[Cost/benefit of preoperative examinations for routine elective surgery].
BACKGROUND
Preoperative exams are a common practice for surgeons; however, their use is not based on a scientific or medical basis. In the best of scenarios, it is an institutional policy.


METHODS
We wanted to determine the utility and cost-effectiveness ratio of of preoperative routine tests (PRT) and we analyzed retrospectively the frequency of complications, hospital stay, and cost-effectiveness of PRT, in subjects with no concomitant disease, who were having elective surgery performed by the general surgery service. We included 141 male and female subjects, ages from 18 to 40 years, during 2002.


RESULTS
There was no increase in complication frequency in patients with PRT abnormalities (6.2% versus 5.1%, OR 0.82, p = 0.78), or hospital stay time (2.37 versus 2.76, p = 0.55). PRT were repeated in 19.1%, expiration being the most frequent reason (46%). Urinalysis was the most frequent abnormal test (21.4%). We found only five clinically relevant abnormalities (3.5%). Only three patients required therapeutic intervention prior to surgery. The detection cost for PRT abnormalities requiring preoperative medical intervention was 22,732 Mexican pesos (approximately USD 2,022).


CONCLUSIONS
The use of PRT in young clinically healthy subjects is an expensive and inefficient practice.
Morales-Orozco
Christian
C
División de Cirugía General, Hospital General Dr. Manuel Gea González.
Mata-Miranda
Maria del Pilar
Mdel P
Cárdenas-Lailson
Luis Eduardo
LE
D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics*; D017558:Elective Surgical Procedures / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D011300:Preoperative Care / Q000191:economics*; D012189:Retrospective Studies