Background: Perioperative laboratory investigations should be obtained for specific indications based on the patient history, physical examination, co morbidities and the type of surgery. A test is likely to be indicated only if it can correctly identify abnormalities and will change the diagnosis, the management plan, or the patient’s outcome. Routine laboratory investigation before surgery is rampant. It seldom however changes the anaesthetic care plan or influence outcome. This research sought to find out the practice of preoperative laboratory testing at the Komfo Anokye Teaching Hospital (K. A. T. H). Methodology: This was a prospective, cross sectional study of patients undergoing elective surgery at K. A. T. H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. Close and open ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anaesthesia assessment. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22. Results: The average age of patients studied was 50 years. Complete blood count (CBC) is the most ordered laboratory investigation at KATH (98.8%). Every patient had at least four (4) laboratory investigations done. At the time of preoperative assessment by the anaesthetist, laboratory investigations had already been ordered by the surgical team in almost all the patients studied (98.8%). The anaesthetists ordered investigations in only 1.2% of the patients. When tests ordered were compared to the Canadian Anesthesiology Society (CAS) guidelines, it was found that 54.4% of renal function test ordered had no indication, as was the case with serum electrolytes 40.4%, coagulation studies 39.9% and complete blood count 23.9%. Conclusion: A lot of laboratory investigations requested for patients undergoing surgery at K. A. T. H have no clinical indication. Members of the surgical team are responsible for ordering the laboratory investigations. Complete blood count is the most frequently ordered investigation.
| Published in | Journal of Anesthesiology (Volume 5, Issue 2) |
| DOI | 10.11648/j.ja.20170502.11 |
| Page(s) | 5-10 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Preoperative, Laboratory Investigations, Elective Surgery, Practice
| [1] | Standards and Practice Parameters, ASA House of Delegates. Routine Preoperative Laboratory and Diagnostic Screening - Google Search [Internet]. 2008 [cited 2013 Oct 14]. |
| [2] | Kumar A, Srivastava U. Role of routine laboratory investigations in preoperative evaluation. J Anaesthesiol Clin Pharmacol. 2011; 27: 174–9. |
| [3] | Hepner DL. The role of testing in the preoperative evaluation. Cleve Clin J Med. 2009; 76: 22–7. |
| [4] | Feely MA, Collins CS, Daniels PR, Kebede EB, Jatoi A, Mauck KF. Preoperative testing before noncardiac surgery: guidelines and recommendations. Am Fam Physician. 2013; 87: 414–8. |
| [5] | Fischer SP, Bader AM, Sweitzer B. Preoperative Evaluation. In: Ronald D Miller, editor. Millers Anesthesia 7th edition. Elsevier Churchill Livingstone 2009: chapter-34. |
| [6] | Smetana GW, Macpherson DS. The case against routine preoperative laboratory testing. Med Clin North Am. 2003; 87: 7–40. |
| [7] | Brown SR, Brown J. Why do physicians order unnecessary preoperative tests? Fam Med. 2011; 43: 338-43. |
| [8] | Apfelbaum JL, Connis RT, Nickinovich DG, Pasternak LR, Arens JF et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012; 116: 522–38. |
| [9] | National Collaborating Centre for Acute Care. NICE Guideline for Preoperative Investigations in Patients Undergoing Elective Surgery 2003 [cited 2013 Oct 10]. |
| [10] | Routine Preoperative Lab Tests for Adult patients (age ≥ 16 years) undergoing Elective Surgery – GRIDFINAL Dec.10.pdf [Internet]. 2010 [cited 2014 Feb 17]. |
| [11] | Merchant R, Chartrand D, Dain S, Dobson G, Kurrek MM et al. Guidelines to the practice of anesthesia. Can J Anesth/ J Can Anesth 2014: 61: 46–71. |
| [12] | Kaplan EB, Sheiner LB, Boeckmann AJ, Roizen MF, Beal SL et al. The usefulness of preoperative laboratory screening. JAMA. 1985; 253: 3576–81. |
| [13] | Johnson H, Knee-Loli S, Butler TA, Munoz E, Wise L. Are routine preoperative laboratory screening tests necessary to evaluate ambulatory surgical patients? Surgery. 1988; 104: 639–45. |
| [14] | Chung F, Yuan H, Yin L, Vairavanathan S, Wong DT. Elimination of Preoperative Testing in Ambulatory Surgery. Anesth Analg. 2009; 108: 467–75. |
| [15] | Vogt AW, Henson LC. Unindicated preoperative testing: ASA physical status and financial implications. J Clin Anesth. 1997; 9: 437–41. |
| [16] | Patey AM, Islam R, Francis JJ, Bryson GL, Grimshaw JM. Anesthesiologists’ and surgeons’ perceptions about routine pre-operative testing in low-risk patients: application of the Theoretical Domains Framework (TDF) to identify factors that influence physicians’ decisions to order pre-operative tests. Implement Sci. 2012; 7: 52. |
| [17] | Thelma Z Korpman. Routine Preoperative Laboratory and Diagnostic Screening. 2014. |
| [18] | Ranasinghe P, Perera YS, Abayadeera A. Preoperative Investigations in Elective Surgery: Practices and Costs at the National Hospital of Sri Lanka. Sri Lankan Journal of Anaesthesiology 2014; 18: 29. |
| [19] | Practice advisory for preanesthesia evaluation: a report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2002; 96: 485-96. |
| [20] | Macpherson DS, Snow R, Lofgren RP. Preoperative screening: value of previous tests. Ann Intern Med 1990; 113: 969-73. |
APA Style
Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi, William Addison. (2017). Preoperative Laboratory Testing in Patients Undergoing Elective Surgery: An Analysis of Practice at Komofo Anokye Teaching Hospital. International Journal of Anesthesia and Clinical Medicine, 5(2), 5-10. https://doi.org/10.11648/j.ja.20170502.11
ACS Style
Akwasi Antwi-Kusi; Bright Ighodaro Obasuyi; William Addison. Preoperative Laboratory Testing in Patients Undergoing Elective Surgery: An Analysis of Practice at Komofo Anokye Teaching Hospital. Int. J. Anesth. Clin. Med. 2017, 5(2), 5-10. doi: 10.11648/j.ja.20170502.11
AMA Style
Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi, William Addison. Preoperative Laboratory Testing in Patients Undergoing Elective Surgery: An Analysis of Practice at Komofo Anokye Teaching Hospital. Int J Anesth Clin Med. 2017;5(2):5-10. doi: 10.11648/j.ja.20170502.11
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Download@article{10.11648/j.ja.20170502.11,
author = {Akwasi Antwi-Kusi and Bright Ighodaro Obasuyi and William Addison},
title = {Preoperative Laboratory Testing in Patients Undergoing Elective Surgery: An Analysis of Practice at Komofo Anokye Teaching Hospital},
journal = {International Journal of Anesthesia and Clinical Medicine},
volume = {5},
number = {2},
pages = {5-10},
doi = {10.11648/j.ja.20170502.11},
url = {https://doi.org/10.11648/j.ja.20170502.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20170502.11},
abstract = {Background: Perioperative laboratory investigations should be obtained for specific indications based on the patient history, physical examination, co morbidities and the type of surgery. A test is likely to be indicated only if it can correctly identify abnormalities and will change the diagnosis, the management plan, or the patient’s outcome. Routine laboratory investigation before surgery is rampant. It seldom however changes the anaesthetic care plan or influence outcome. This research sought to find out the practice of preoperative laboratory testing at the Komfo Anokye Teaching Hospital (K. A. T. H). Methodology: This was a prospective, cross sectional study of patients undergoing elective surgery at K. A. T. H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. Close and open ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anaesthesia assessment. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22. Results: The average age of patients studied was 50 years. Complete blood count (CBC) is the most ordered laboratory investigation at KATH (98.8%). Every patient had at least four (4) laboratory investigations done. At the time of preoperative assessment by the anaesthetist, laboratory investigations had already been ordered by the surgical team in almost all the patients studied (98.8%). The anaesthetists ordered investigations in only 1.2% of the patients. When tests ordered were compared to the Canadian Anesthesiology Society (CAS) guidelines, it was found that 54.4% of renal function test ordered had no indication, as was the case with serum electrolytes 40.4%, coagulation studies 39.9% and complete blood count 23.9%. Conclusion: A lot of laboratory investigations requested for patients undergoing surgery at K. A. T. H have no clinical indication. Members of the surgical team are responsible for ordering the laboratory investigations. Complete blood count is the most frequently ordered investigation.},
year = {2017}
}
TY - JOUR T1 - Preoperative Laboratory Testing in Patients Undergoing Elective Surgery: An Analysis of Practice at Komofo Anokye Teaching Hospital AU - Akwasi Antwi-Kusi AU - Bright Ighodaro Obasuyi AU - William Addison Y1 - 2017/03/29 PY - 2017 N1 - https://doi.org/10.11648/j.ja.20170502.11 DO - 10.11648/j.ja.20170502.11 T2 - International Journal of Anesthesia and Clinical Medicine JF - International Journal of Anesthesia and Clinical Medicine JO - International Journal of Anesthesia and Clinical Medicine SP - 5 EP - 10 PB - Science Publishing Group SN - 2997-2698 UR - https://doi.org/10.11648/j.ja.20170502.11 AB - Background: Perioperative laboratory investigations should be obtained for specific indications based on the patient history, physical examination, co morbidities and the type of surgery. A test is likely to be indicated only if it can correctly identify abnormalities and will change the diagnosis, the management plan, or the patient’s outcome. Routine laboratory investigation before surgery is rampant. It seldom however changes the anaesthetic care plan or influence outcome. This research sought to find out the practice of preoperative laboratory testing at the Komfo Anokye Teaching Hospital (K. A. T. H). Methodology: This was a prospective, cross sectional study of patients undergoing elective surgery at K. A. T. H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. Close and open ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anaesthesia assessment. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22. Results: The average age of patients studied was 50 years. Complete blood count (CBC) is the most ordered laboratory investigation at KATH (98.8%). Every patient had at least four (4) laboratory investigations done. At the time of preoperative assessment by the anaesthetist, laboratory investigations had already been ordered by the surgical team in almost all the patients studied (98.8%). The anaesthetists ordered investigations in only 1.2% of the patients. When tests ordered were compared to the Canadian Anesthesiology Society (CAS) guidelines, it was found that 54.4% of renal function test ordered had no indication, as was the case with serum electrolytes 40.4%, coagulation studies 39.9% and complete blood count 23.9%. Conclusion: A lot of laboratory investigations requested for patients undergoing surgery at K. A. T. H have no clinical indication. Members of the surgical team are responsible for ordering the laboratory investigations. Complete blood count is the most frequently ordered investigation. VL - 5 IS - 2 ER -
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