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 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… 
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37 Citations
Highly Influential Citations
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Background Citations
5
Methods Citations
2
Results Citations
1

37 Citations

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.
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.
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.
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.
Role of Patient- and Surgery-Specific Risk in Receipt of Outpatient Preoperative Testing.
Development and Validation of a Risk-Based Algorithm for Preoperative Type and Screen Testing in Spine Surgery.
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.
Preoperative laboratory data are associated with complications and surgical site infection in composite head and neck surgical resections.
Routine perioperative practices and postoperative outcomes for elective lumbar laminectomies.
TLDR
Hospital policies should be re-evaluated to address the overuse of unnecessary preoperative investigations for elective lumbar laminectomies, which have low perioperative transfusion and complication rates.
Prevalence and Cost of Care Cascades After Low-Value Preoperative Electrocardiogram for Cataract Surgery in Fee-for-Service Medicare Beneficiaries.
TLDR
Care cascades after preoperative EKG for cataract surgery are infrequent but costly, and policy and practice interventions to reduce low-value services and the cascades that follow could yield substantial savings.
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