Pipal Dharmendra Kumar, Kochar Shubham, Kumar Umesh, Yadav Umesh, Arora Bhumika, Vardhan Vikram, Biswas Prakash, Pipal Vibha Rani, Pipal Rajendra Kumar, Yadav Seema, Sharma Ravi Shankar
All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
Pt B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.
J West Afr Coll Surg. 2025 Jul-Sep;15(3):282-290. doi: 10.4103/jwas.jwas_43_24. Epub 2024 Oct 1.
In recent decades, experts have questioned the necessity of routine preoperative investigations due to their limited influence on perioperative management, higher expenses, postponed surgical procedures, patient anxiety resulting from false-positive results for minor operations and increased workload for laboratories.
Our objective was to systematically evaluate the impact of pre-operative investigations on the treatment of patients opting for elective procedures. The study aimed to evaluate the impact of pre-operative investigations and peri-operative management on elective surgeries of the American Society of Anesthesiologists (ASA) physical status classification grades I and II, identifying common inappropriate investigations and assessing the impact of abnormal results on patient management.
We conducted a prospective, cross-sectional, clinical, observational, single-centre study from February 2020 to March 2021 on 500 cases in the General Surgery Department of Tertiary Care Teaching Hospital. This study assessed the importance of pre-operative investigations in low-risk patients undergoing low-grade elective general surgical procedures. We recruited consecutive patients from the surgery wards of the institute, who fulfilled the inclusion criteria and obtained informed written consent for anaesthesia, surgery and participation in the study. Demographic data, the type of investigation conducted and test results were noted. We followed up with patients who had abnormal test results to record the consequences of the abnormality, such as the postponement of surgery and the requirement for additional investigations. Pre-operative transfusion, change in the management plan and change in the anaesthesia plan were recorded.
In the current study, the age of the patients ranged from 20 years to 45 years, and the mean age of the patients was 32.208 ± 9.16. The age group of 20-30 years was the commonest, being 158 (31.6%) patients. Out of 500 patients, 296 (59.2%) patients were males and the remaining 204 (40.8%) were female patients. Out of 500 tests, 44 (8.8%) had abnormal results. Most of the changes in our study were based on abnormal ECG findings. Out of a total of 500 surgical procedures performed, 497 (99.4%) were carried out without any difficulty, with two (0.4%) postponed due to abnormality in the pre-operative investigations and one (0.2%) cancelled. A total of 490 (98%) patients did not have any post-operative complications. Only ten (2%) patients developed post-operative complications, and out of those, only one (0.1%) had some abnormality in the pre-operative investigations.
Preoperative laboratory investigations do not significantly influence the surgical outcome of the patients belonging to ASA grades I and II.
近几十年来，由于常规术前检查对围手术期管理影响有限、费用较高、手术推迟、小手术假阳性结果导致患者焦虑以及实验室工作量增加，专家们对其必要性提出了质疑。
我们的目的是系统评估术前检查对选择择期手术患者治疗的影响。该研究旨在评估术前检查和围手术期管理对美国麻醉医师协会（ASA）身体状况分级为I级和II级的择期手术的影响，识别常见的不适当检查，并评估异常结果对患者管理的影响。
我们于2020年2月至2021年3月在一家三级护理教学医院的普通外科对500例患者进行了一项前瞻性、横断面、临床、观察性单中心研究。本研究评估了低风险患者接受低级别择期普通外科手术时术前检查的重要性。我们从该机构的手术病房招募了符合纳入标准并获得麻醉、手术及参与研究知情书面同意的连续患者。记录人口统计学数据、进行的检查类型和检查结果。我们对检查结果异常的患者进行随访，记录异常的后果，如手术推迟和额外检查的需求。记录术前输血情况、管理计划的改变和麻醉计划的改变。
在本研究中，患者年龄范围为20岁至45岁，平均年龄为32.208±9.16岁。20 - 30岁年龄组最为常见，有158例（31.6%）患者。在500例患者中，296例（59.2%）为男性，其余204例（40.8%）为女性患者。在500项检查中，44项（8.8%）结果异常。我们研究中的大多数改变是基于心电图异常发现。在总共进行的500例手术中，497例（99.4%）顺利完成，2例（0.4%）因术前检查异常而推迟，1例（0.2%）取消。共有490例（98%）患者无术后并发症。只有10例（2%）患者出现术后并发症，其中只有1例（0.1%）术前检查有一些异常。
术前实验室检查对ASA I级和II级患者的手术结果无显著影响。
