Efficacy of Preadmission Testing in Ambulatory Surgical Patients

Am J Surg. 1992 Jun;163(6):565-70; discussion 571. doi: 10.1016/0002-9610(92)90557-8.

Abstract

A retrospective study was done with 325 patients who had preadmission testing prior to ambulatory surgery. At least one laboratory abnormality was noted in 84% of the patients. The serial multiple analysis (SMA)-7 was abnormal 63% of the time. Abnormalities were seen in 54% of the SMA-12 panels and 38% of the urinalyses performed. Twenty-four percent of the patients treated had an abnormal electrocardiogram (ECG). An abnormal chest roentgenogram was found in 19% of the patients. Only three (1%) patients potentially benefited from preadmission testing. Ninety-six percent of the abnormal laboratory results were ignored by the attending physicians. Therefore, we conclude that preadmission testing should be done on a selective basis. Patients older than 50 years of age should have an ECG. A hematocrit should be obtained only if major blood loss is anticipated. All other tests should be ordered based on the history and physical examination.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures* / statistics & numerical data
  • Anesthesia, General
  • Anesthesia, Local
  • Blood Chemical Analysis / statistics & numerical data
  • Diagnostic Tests, Routine* / statistics & numerical data
  • Electrocardiography / statistics & numerical data
  • Female
  • Genital Diseases, Female / surgery
  • Humans
  • Male
  • Middle Aged
  • New York / epidemiology
  • Otorhinolaryngologic Diseases / surgery
  • Radiography, Thoracic / statistics & numerical data
  • Retrospective Studies
  • Urine / chemistry
  • Urine / cytology