title: Utilization of Preoperative Laboratory Testing for Low-risk, Ambulatory Urologic Procedures.
abstract: To determine the clinical significance of preoperative laboratory testing for low-risk ambulatory urologic procedures.
  
  
  
  The National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2013 was queried for urethral sling procedures, cystoscopic procedures, and scrotal procedures. Multivariate analysis was used to assess for independent predictors of preoperative laboratory testing utilization and for postoperative complications.
  
  
  
  Overall, 7378 procedures were identified, with 73.9% undergoing 1 or more laboratory tests, including 37.9% who had no comorbidities. Patients who were tested were older, had a higher American Society of Anesthesiologists class, and had more preoperative comorbidities. Of these procedures, only 2.9% resulted in any complication. Most laboratory tests were drawn within 1 week of the procedure. On multivariate analysis of testing utilization, increasing age and medical comorbidities were predictive of testing. Multivariate analysis of postoperative outcomes showed that abnormal test laboratory findings were not predictive of postoperative complications in those with and without NSQIP-defined comorbidities.
  
  
  
  Abnormal preoperative laboratory testing was not a significant independent predictor of postoperative complications. Almost 40% of patients received preoperative testing despite having no NSQIP-detected comorbid conditions. A multidisciplinary approach should be taken to define procedures in which preoperative laboratory testing may be eliminated.
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY. Electronic address: ws2375@cumc.columbia.edu.
authors.forename: Wilson
authors.initials: W
authors.lastname: Sui
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Marissa C
authors.initials: MC
authors.lastname: Theofanides
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Matulay
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Maxwell B
authors.initials: MB
authors.lastname: James
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Ifeanyi C
authors.initials: IC
authors.lastname: Onyeji
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Arindam
authors.initials: A
authors.lastname: RoyChoudhury
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Matthew
authors.initials: M
authors.lastname: Rutman
mesh_terms: D000556:Ambulatory Surgical Procedures; D019411:Clinical Laboratory Techniques; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D013520:Urologic Surgical Procedures