[Usefulness of admission biochemical tests for general medical patients]

To evaluate the diagnostic utility of admission biochemical tests in the "Essential Laboratory Tests" proposed by the Japan Society of Clinical Pathology, we examined performance, abnormality and undetected abnormality in the tests of 250 randomly selected new patients admitted to the internal medicine wards of a prefectural general hospital during a year period. Each admission biochemical test was performed in 63% to 93% of the patients, and abnormal rates were obtained in 13% to 53% of each type of test performed. It is noteworthy that 37% of the patients were positive for HCV antibody and 32% had elevated blood glucose levels. In 28 of 250 patients, clinical diagnoses were supplemented or changed because of abnormal test results. However, in 15 cases, significant test results were overlooked. To promote appropriate action by the attending physician, we presented interpretative laboratory reports. Clinical usefulness of the reports was also evaluated. During the past four years, 100 interpretative biochemical test reports were accumulated. Diagnoses and treatments were supplemented or changed in 36 cases and 26 cases, respectively, because of the reports. In conclusion, effective and appropriate use of biochemical tests is promoted by interpretative reports.