Preoperative laboratory evaluation of patients aged over 40 years undergoing elective non-cardiac surgery

Sao Paulo Medical Journal

Fábio Yoshito Ajimura¹  Alex Silva Santos Freire Maia¹  Adriana Hachiya¹  Alexandra Sayuri Watanabe¹  Maria Do Patrocínio Tenório Nunes¹  Mílton De Arruda Martins¹  Fábio Santana Machado¹ 

[1] ,Universidade de São Paulo School of Medicine Department of MedicineSão Paulo,Brazil

关键词: Preoperative care;    Blood tests;    Routine diagnostic tests;    Intraoperative complications;    Laboratory techniques and procedures;    Cuidados pré-operatórios;    Testes hematológicos;    Testes diagnósticos de rotina;    Complicações intra-operatórias;    Técnicas e procedimentos de laboratório;   

DOI  :  10.1590/S1516-31802005000200003

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Although it is generally agreed that a medical history and physical examination should be obtained as part of preoperative evaluation, there is still substantial controversy about the additional benefits of preoperative screening tests. The objective of the present study was to determine the percentage of abnormalities on laboratory tests among a population that underwent non-cardiac surgery and to correlate these tests with changes in preoperative evaluation management. DESIGN AND SETTING: Cross-sectional study, carried out in a University Hospital. METHODS: 991 patients aged over 40 years undergoing elective non-cardiac surgery from July 1997 to January 2000 were studied. Blood cell count, serum sodium, potassium, urea and creatinine, prothrombin, thrombin and partial thromboplastin time, electrocardiogram and chest X-ray were evaluated. RESULTS: Out of the 957 electrocardiograms performed, some type of abnormality was found in 504 cases (50.9%) and, among the 646 chest X-rays requested, 271 (42.0%) displayed alterations. Laboratory tests showed abnormal values ranging from 5.1% (prothrombin time) to 41.0% (hematocrit). Increased percentages of abnormal tests with increasing patient age were also observed. CONCLUSIONS: Although there were substantial numbers of screening test abnormalities in preoperative evaluations, these results seldom interfered in patient management.

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