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Preoperative laboratory evaluation of patients aged over 40 years undergoing elective non-cardiac surgery

机译:40岁以上择期非心脏手术患者的术前实验室评估

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CONTEXT AND OBJECTIVE: Although it is generally agreed that a medical history and physical examination should be obtained as part of preoperative evaluation, there is still substantial controversy about the additional benefits of preoperative screening tests. The objective of the present study was to determine the percentage of abnormalities on laboratory tests among a population that underwent non-cardiac surgery and to correlate these tests with changes in preoperative evaluation management. DESIGN AND SETTING: Cross-sectional study, carried out in a University Hospital. METHODS: 991 patients aged over 40 years undergoing elective non-cardiac surgery from July 1997 to January 2000 were studied. Blood cell count, serum sodium, potassium, urea and creatinine, prothrombin, thrombin and partial thromboplastin time, electrocardiogram and chest X-ray were evaluated. RESULTS: Out of the 957 electrocardiograms performed, some type of abnormality was found in 504 cases (50.9%) and, among the 646 chest X-rays requested, 271 (42.0%) displayed alterations. Laboratory tests showed abnormal values ranging from 5.1% (prothrombin time) to 41.0% (hematocrit). Increased percentages of abnormal tests with increasing patient age were also observed. CONCLUSIONS: Although there were substantial numbers of screening test abnormalities in preoperative evaluations, these results seldom interfered in patient management.
机译:内容与目的:尽管通常都同意在术前评估中应获得病史和体格检查,但对于术前筛查试验的其他益处仍然存在争议。本研究的目的是确定接受非心脏手术的人群中实验室检查异常的百分比,并将这些检查与术前评估管理的变化相关联。设计与环境:横断面研究,在大学医院进行。方法:对1997年7月至2000年1月进行的择期非心脏手术的年龄在40岁以上的991例患者进行了研究。评估血细胞计数,血清钠,钾,尿素和肌酐,凝血酶原,凝血酶和部分凝血活酶的时间,心电图和胸部X光片。结果:在进行的957张心电图中,发现504例(50.9%)的某种类型的异常,并且在所请求的646例胸片中,有271例(42.0%)显示出异常。实验室测试显示异常值范围为5.1%(凝血酶原时间)至41.0%(血细胞比容)。还观察到异常检查的百分比随着患者年龄的增加而增加。结论:尽管术前评估中存在大量筛查测试异常,但这些结果很少干扰患者的治疗。

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