A prospective evaluation of preoperative screening laboratory tests in general surgery patients.

OBJECTIVE To assess the value of routine biochemical and hematological screening of otherwise healthy patients prior to elective general surgery. MATERIALS AND METHODS Prospective laboratory screening tests were done for 1,000 consecutive patients undergoing elective general surgery at Mubarak Al-Kabeer Hospital, Kuwait, from January to August 1999. Patients with abnormal laboratory results were interviewed and examined preoperatively as part of the present study protocol, to identify a possible cause for the abnormal laboratory result. The perioperative course of these patients was also monitored. RESULTS Approximately 14% of the preoperative tests were abnormal, 9.2% of which was expected while 4.9% was unexpected; there was no change in the preoperative care of patients with unexpected abnormalities, nor was there surgical delay or related postoperative complication. CONCLUSION The results indicate that laboratory tests should be selectively used when the patient has appropriate risk factors. Instead, greater emphasis should be placed on history and physical examination. Application of such policy will result in substantial financial savings that could be utilized to improve the health care system.