Preoperative Laboratory Investigations: Rates and Variability Prior to Low-risk Surgical Procedures

@article{Kirkham2016PreoperativeLI,
  title={Preoperative Laboratory Investigations: Rates and Variability Prior to Low-risk Surgical Procedures},
  author={K R Kirkham and Duminda N. Wijeysundera and Ciara Pendrith and Ryan Ng and Jack V. Tu and Andrew S Boozary and Joshua D. Tepper and Michael J. Schull and Wendy S Levinson and R. Sacha Bhatia},
  journal={Anesthesiology},
  year={2016},
  volume={124},
  pages={804–814}
}
Background:Increasing attention has been focused on low-value healthcare services. Through Choosing Wisely campaigns, routine laboratory testing before low-risk surgery has been discouraged in the absence of clinical indications. The authors investigated rates, determinants, and institutional variation in laboratory testing before low-risk procedures. Methods:Patients who underwent ophthalmologic surgeries or predefined low-risk surgeries in Ontario, Canada, between April 1, 2008, and March 31… Expand
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Influence of Institution-Based Factors on Preoperative Blood Testing Prior to Low-Risk Surgery: A Bayesian Generalized Linear Mixed Approach
TLDR
It is indicated that preoperative blood tests are strongly influenced by institutional factors, suggesting that specific guidelines should be developed to avoid excessive preoperative testing for low-risk surgery. Expand
Preoperative pulmonary function tests before low-risk surgery in Japan: a retrospective cohort study using a claims database
TLDR
The authors' analysis found that preoperative PFTs were performed before 72% of low-risk surgeries under general anesthesia and were associated with older age, number of beds at a medical facility, and inpatient procedures. Expand
Preoperative Blood Tests Conducted Before Low-Risk Surgery in Japan: A Retrospective Observational Study Using a Nationwide Insurance Claims Database
TLDR
Preoperative blood tests were performed before 59.5% of low-risk surgeries in Japan and were associated with the type of anesthesia, patient characteristics, and medical facility status. Expand
Prevalence and Factors Associated With Low-Value Preoperative Testing for Patients Undergoing Carpal Tunnel Release at an Academic Medical Center.
TLDR
Low-value preoperative tests were frequently received by patients undergoing CTR and were associated with anesthesia type, age, and number of comorbidities, which can help guide efforts to improve the quality and value of surgery for carpal tunnel syndrome and facilitate the development of strategies to reduce LVT. Expand
The Utility of Preoperative Laboratory Testing in Assessing Risk of Adverse Outcomes Following Anterior Cervical Discectomy and Fusion: Insights from a National Surgical Registry.
TLDR
It is indicated that abnormal preoperative lab values are associated with increased risk for adverse outcomes following elective ACDF and can be used in predictive analyses of outcomes. Expand
Role of Patient- and Surgery-Specific Risk in Receipt of Outpatient Preoperative Testing.
TLDR
Surgery-specific risk is strongly associated with receipt of most preoperative tests, which is consistent with preoperative testing protocols based as much or more on the planned operation as on patient- specific risk factors, whether this pattern of preoperativeTesting represents optimal care is uncertain. Expand
Use of preoperative haemostasis and ABO blood typing tests in children: a retrospective observational study using a nationwide claims database in Japan
TLDR
In the largest Japanese cohort reported to date, preoperative haemostasis and ABO blood typing tests were performed in a majority of children prior to common paediatric surgeries, and were associated with anaesthesia, surgical type and surgical setting. Expand
The impact of reduction of testing at a Preoperative Evaluation Clinic for elective cases: Value added without adverse outcomes.
TLDR
A net reduction in preoperative testing was seen at Vanderbilt's Preoperative Evaluation Clinic from 2012 to 2015 due to anesthesia protocol changes intended to limit routine ordering of labs and imaging. Expand
Rethinking the routine: Preoperative laboratory testing among American Society of Anesthesiologists class 1 and 2 patients before low-risk ambulatory surgery in the 2017 National Surgical Quality Improvement Program cohort.
TLDR
Preoperative testing should be used more judiciously in this population, which may lead to cost savings and differences in the rates of complications between patients with and without testing is low. Expand
Preoperative laboratory data are associated with complications and surgical site infection in composite head and neck surgical resections.
TLDR
Findings identify laboratory studies to focus on during H&N resection preoperative assessments and determine complication, surgical site infection (SSI), and transfusion predictors by laboratory test. Expand
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