Preoperative laboratory screening in healthy Mayo patients: cost-effective elimination of tests and unchanged outcomes.
We reviewed the results of preoperative screening laboratory tests in asymptomatic healthy patients who underwent elective surgical procedures at our institution in 1988. Substantially abnormal results were found in 160 of 3,782 patients. All such abnormalities involved five tests: aspartate aminotransferase, glucose, potassium, platelet count, and hemoglobin. Thirty of the abnormal test results were predictable on the basis of the history or physical examination. The abnormal test result prompted further assessment in 47 patients. No surgical procedure was delayed, and no association was noted between adverse outcome and any preoperative laboratory abnormality. Because of our findings in this analysis and similar studies on specific tests from other institutions, we no longer require preoperative laboratory screening tests for healthy patients.
Narr
B J
BJ
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905.
Hansen
T R
TR
Warner
M A
MA
D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics*; D004469:Economics, Hospital; D006777:Hospitals, Proprietary; D006801:Humans; D008910:Minnesota; D010043:Outcome and Process Assessment, Health Care; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative