Patterns of preoperative laboratory testing in patients undergoing outpatient plastic surgery procedures.
Publication/Presentation Date
1-1-2014
Abstract
BACKGROUND: Preoperative laboratory testing is commonplace in the clinical setting and is often utilized at surgeon discretion. We searched the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) data set to determine the impact of preoperative laboratory testing in ambulatory plastic surgery patients.
OBJECTIVE: The authors assess the utilization and predictive value of preoperative laboratory testing in outpatient plastic surgery procedures.
METHODS: Patients undergoing ambulatory plastic surgery were identified from the 2005 to 2010 NSQIP databases. Laboratory tests were categorized by group: hematologic, chemistry, coagulation, and liver function tests (LFT). We defined complications in 2 groups: major postoperative and wound complications. Multivariate analyses were used to identify patient characteristics associated with testing and to assess the ability of laboratory testing to predict postoperative complications.
RESULTS: A total of 5359 (62.0%) patients underwent testing; 881 (16.4%) tests were performed on the day of surgery. In patients with no defined NSQIP comorbidities, 59.4% underwent preoperative testing and had a significantly lower rate of abnormal findings (33.4% vs 25.3%, P < .0001). In multivariate analyses, testing was associated with older age, American Society of Anesthesiologists class >2, Hispanic or African American race, body contouring procedures, epidural or spinal procedures, and with diabetes, hypertension, and cancer. Major complications occurred in 0.34% of patients. Our analysis demonstrated that neither testing nor abnormal results were associated with postoperative complications, either major (P = .178) or wound (P = .150).
CONCLUSIONS: We found no association between abnormal laboratory testing and postoperative morbidity. Preoperative testing in low-risk ambulatory plastic surgery patients may be costly and has limited direct clinical benefit.
Volume
34
Issue
1
First Page
133
Last Page
141
ISSN
1527-330X
Published In/Presented At
Fischer, J. P., Shang, E. K., Nelson, J. A., Wu, L. C., Serletti, J. M., & Kovach, S. J. (2014). Patterns of preoperative laboratory testing in patients undergoing outpatient plastic surgery procedures. Aesthetic surgery journal, 34(1), 133–141. https://doi.org/10.1177/1090820X13515880
Disciplines
Medicine and Health Sciences
PubMedID
24334303
Department(s)
Department of Surgery
Document Type
Article