From the Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL.
Female Pelvic Med Reconstr Surg. 2020 Sep;26(9):550-553. doi: 10.1097/SPV.0000000000000606.
The objective of this study was to determine the incidence of newly diagnosed, clinically meaningful laboratory abnormalities on routine preoperative laboratory testing in women undergoing urogynecologic surgery.
All urogynecologic cases performed at a single institution over a 3-year period were reviewed. Women undergoing major surgery routinely had a basic metabolic panel, complete blood count (CBC), and type and screen, whereas women undergoing minor surgery had testing at the surgeon's discretion. Demographics, surgical details, preoperative laboratory values, and instances of postoperative transfusion were abstracted. If testing revealed a clinically meaningful abnormality, physician notes were reviewed to determine whether the abnormality was previously known or led to surgical postponement.
A total of 836 cases were identified: 411 major (49%) and 425 minor (51%). Patients had a mean ± SD age of 57 ± 13 years and body mass index of 27 ± 6 kg/m. Medical comorbidities were hypertension, 38%; diabetes, 24%; chronic kidney disease, 3%; and congestive heart failure, 4%; 89% had an American Society of Anesthesiologists class of less than or equal to 2. A total of 453 (54%) had preoperative CBC, and 367 (44%) had preoperative basic metabolic panel. Six (1.3%) new abnormalities (hemoglobin between 8.0 and 10.0) were identified on CBC. Thirty-one women had elevated creatinine level (>1.0), and 28 (90%) of these had a history of hypertension. No surgeries were postponed or changed owing to anemia, thrombocytopenia, or renal dysfunction. No clinically significant electrolyte abnormalities were identified. Type and screen were collected on 394 patients; none were transfused intraoperatively.
Routine preoperative laboratory testing does not identify clinically meaningful abnormalities or alter surgical management in women undergoing urogynecologic surgery.
本研究旨在确定在接受妇科泌尿手术的女性中，常规术前实验室检查中新诊断出的具有临床意义的实验室异常的发生率。
回顾了一家机构在 3 年内进行的所有妇科泌尿病例。接受大手术的女性常规进行基本代谢小组检查、全血细胞计数（CBC）和血型和筛选，而接受小手术的女性则由外科医生决定进行检查。提取人口统计学、手术细节、术前实验室值和术后输血的情况。如果检查发现具有临床意义的异常，则查阅医生的记录以确定该异常是先前已知的还是导致手术推迟。
共确定了 836 例病例：411 例为大手术（49%），425 例为小手术（51%）。患者的平均年龄为 57±13 岁，体重指数为 27±6kg/m。合并症为高血压，占 38%；糖尿病，占 24%；慢性肾脏病，占 3%；充血性心力衰竭，占 4%；美国麻醉医师协会分级小于或等于 2 级的患者占 89%。有术前 CBC 的患者共 453 例（54%），有术前基本代谢小组检查的患者共 367 例（44%）。CBC 发现 6 例（1.3%）新异常（血红蛋白 8.0-10.0）。31 名女性的肌酐水平升高（>1.0），其中 28 名（90%）有高血压病史。由于贫血、血小板减少或肾功能障碍而推迟或改变手术的情况并不存在。未发现具有临床意义的电解质异常。收集了 394 例患者的血型和筛选，没有患者在手术中输血。
在接受妇科泌尿手术的女性中，常规术前实验室检查不能发现具有临床意义的异常或改变手术管理。
