Shaner Julie L, Karim Ammar R, Casper David S, Ball Christopher J, Padegimas Eric M, Lonner Jess H
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Orthopaedic Surgery, Rowan University School of Osteopathic Medicine, Stratford, New Jersey.
J Arthroplasty. 2016 Dec;31(12):2764-2767. doi: 10.1016/j.arth.2016.05.052. Epub 2016 May 31.
While partial knee arthroplasty (PKA) is increasingly performed on an outpatient basis, many surgeons still admit patients overnight and obtain laboratory studies on the first postoperative day. The purpose of this study was to investigate the utility and cost effectiveness of routine postoperative laboratory studies after PKA.
This is a retrospective review of 322 consecutive unilateral or bilateral simultaneous PKAs (unicompartmental, patellofemoral, and modular bicompartmental knee arthroplasty) performed by a single surgeon. There were 408 complete blood counts and basic metabolic panels ordered.
Despite a large number of laboratory studies ordered and abnormalities detected, there was a 1.6% rate of laboratory-associated interventions (for either hypokalemia or hyperglycemia in 5 patients) and no red blood cell transfusions. Hospital charges associated with laboratory studies totaled $85,413. There were no 90-day postoperative hospital readmissions or emergency department evaluations related to abnormal postoperative laboratory values.
With an increasing emphasis placed on cost containment, the low rate of laboratory-associated interventions after PKA suggests that routinely obtaining laboratory studies are neither necessary nor cost effective.
虽然部分膝关节置换术（PKA）越来越多地在门诊进行，但许多外科医生仍会让患者住院过夜，并在术后第一天进行实验室检查。本研究的目的是调查PKA术后常规实验室检查的实用性和成本效益。
这是一项对由单一外科医生连续进行的322例单侧或双侧同时进行的PKA（单髁、髌股关节和模块化双髁膝关节置换术）的回顾性研究。共进行了408次全血细胞计数和基本代谢指标检测。
尽管进行了大量的实验室检查并检测到异常，但实验室相关干预率为1.6%（5例患者出现低钾血症或高血糖），且无红细胞输血情况。与实验室检查相关的医院费用总计85,413美元。术后90天内没有因术后实验室值异常而再次入院或到急诊科就诊的情况。
随着对成本控制的日益重视，PKA术后实验室相关干预率较低表明，常规进行实验室检查既无必要也不具有成本效益。
