Velanovich V
Department of Surgery, Letterman Army Medical Center, Presidio of San Francisco, Calif.
Surgery. 1991 Mar;109(3 Pt 1):236-43.
The purpose of this study was to evaluate the ability of preoperative laboratory testing to predict postoperative complications. Five hundred twenty patients undergoing elective surgery had their American Society of Anesthesiologists' classification, ponderal index, electrolyte values, glucose levels, blood urea nitrogen/creatinine values, complete blood counts, coagulation studies, total protein/albumin/lymphocyte count, electrocardiogram, chest radiograph, urinalysis, pulmonary function tests, type of anesthesia, and type of operation recorded preoperatively. Patients were followed prospectively after surgery for the development of complications. The data were analyzed by univariate and multivariate methods. Postoperative complications were strongly associated with American Society of Anesthesiologists' classification, type of anesthesia, and type of operation. However, only a few laboratory tests, such as electrocardiogram, chest radiograph, and nutritional status, were associated with postoperative complications. Therefore, in general, preoperative laboratory testing should only be undertaken for specific indications. Recommendations for routine tests are made depending on the age of the patient.
本研究的目的是评估术前实验室检查预测术后并发症的能力。520例接受择期手术的患者术前记录了其美国麻醉医师协会分级、体重指数、电解质值、血糖水平、血尿素氮/肌酐值、全血细胞计数、凝血研究、总蛋白/白蛋白/淋巴细胞计数、心电图、胸部X线片、尿液分析、肺功能测试、麻醉类型和手术类型。术后对患者进行前瞻性随访以观察并发症的发生情况。采用单因素和多因素方法对数据进行分析。术后并发症与美国麻醉医师协会分级、麻醉类型和手术类型密切相关。然而,只有少数实验室检查,如心电图、胸部X线片和营养状况,与术后并发症有关。因此,一般来说,术前实验室检查仅应针对特定指征进行。根据患者年龄给出了常规检查的建议。