Current preoperative testing practices in ambulatory surgery are widely disparate: a survey of CAS members

Abstract

P Pu ur rp po os se e: : Routine preoperative testing has been criticized as having little impact on perioperative outcomes. The purpose of this study is to identify the current practice of preoperative testing in ambulatory surgery.

Routine preoperative electrocardiogram and chest x-ray prior to elective surgery in Alberta, Canada

“…H However, some guidelines suggest that age alone should not be the indication to order the tests. 9 Rather, the tests should be ordered according to patients' clinical features.…”

Role of routine laboratory investigations in preoperative evaluation

“…[1134] There is growing evidence that physiological age with overall health condition and invasiveness of surgery rather than chronological age should determine the need of tests especially ECG. [3447]…”

“…[4748] In an attempt to rationalize this issue, guidelines have been systematically developed after analysis of studies, best evidence available, and consensus of expert professionals. [14151819203049] Preoperative diagnosis-based guidelines provide basic recommendations for laboratory and other tests [Table 2, based on the guidelines available in text books of anesthesia and scientific journals].…”

“…[12] They should be audited as warranted by evolution of medical knowledge, technology, and pattern of practice. [123247]…”

“…[81319373850] Still 30-60% tests continue to be greatly in excess of that recommended. [1247] It is a matter of great concern that despite clear results of innumerable studies and recommendations from professional societies, after nearly 30 years, the dissemination and adoption of guidelines to routine practice is problematical. [21618] The reasons why clinicians continue to order the routine tests before surgery are not clear[26] but a number of reasons have been suggested.…”