title: Usefulness of routine preoperative testing in a developing country: a prospective study.
abstract: BACKGROUND
  The assessment of anesthetic risks is an essential component of preoperative evaluation. In developing world, preanesthesia evaluation may be challenging because patient's medical history and records are scare, and language barrier limits physical examination. Our objective was to evaluate the impact of routine preoperative testing in a low-resources setting.
  
  
  METHODS
  Prospective observational study performed in a French forward surgical unit in Abidjan, Ivory Coast. 201 patients who were scheduled for non urgent surgery were screened with routine laboratory exams during preoperative evaluation. Changes in surgery were assessed (delayed or scheduled).
  
  
  RESULTS
  Abnormal hemoglobin findings were reported in 35% of patients, abnormal WBC count in 11,1% of patients, abnormal platelets in 15,3% of patients. Positive HIV results were found in 8,3% of cases. Routine tests represented 43,6% of changes causes.
  
  
  CONCLUSIONS
  Our study showed that in a developing country, routine preoperative tests showed abnormal results up to 35% of cases, and represented 43,5% of delayed surgery causes. The rate of tests leading to management changes varied widely, from 0% to 8,3%. These results suggested that selected tests would be useful to diagnose diseases that required treatment before non urgent surgery. However, larger studies are needeed to evaluate the cost/benefit ratio and the clinical impact of such a strategy.
authors.affiliation: Département d'Anesthésie-Réanimation, HIA Sainte Anne, Toulon, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Bordes
authors.affiliation: Département d'Anesthésie-Réanimation, HIA Sainte Anne, Toulon, France.
authors.forename: Pierre-Julien
authors.initials: PJ
authors.lastname: Cungi
authors.affiliation: Service d'Urologie, HIA Sainte Anne, Toulon, France.
authors.forename: Pierre-Henry
authors.initials: PH
authors.lastname: Savoie
authors.affiliation: Service de Chirurgie Viscérale, HIA Percy, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bonnet
authors.affiliation: Département d'Anesthésie-Réanimation, HIA Sainte Anne, Toulon, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Kaiser
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D007560:Cote d'Ivoire; D003906:Developing Countries; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012306:Risk; D055815:Young Adult
keywords: Diagnostic tests; HIV Infections; preoperative period; surgical Procedures