The prevalence of inappropriate blood tests in pediatric patients scheduled for elective surgery in Thailand: a retrospective chart review
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 809 - 815
DOI: https://doi.org/10.5372/1905-7415.0906.455
Keywords
© 2015 Naiyana Aroonpruksakul, Thaniya Stimanont, Pattira Pianchob
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Laboratory blood tests rarely detect any abnormalities in apparently healthy patients. Moreover, unnecessary testing may not only upset pediatric patients and their parents, but may harm patients because of overtreatment of borderline or false-positive results.
Objectives
To determine the prevalence and factors correlated with inappropriate preoperative testing of pediatric patients scheduled for elective surgery.
Methods
We conducted a 6-month retrospective chart review of all children <15 years of age who underwent elective surgery at Siriraj Hospital in Bangkok, Thailand. Demographic and clinical data were recorded, including age, sex, physical status class according to the American Society of Anesthesiologists (ASA), underlying diseases, diagnosis, operation, service unit, and grade of surgery. The requested preoperative laboratory tests were based on the surgeon’s decision. We assessed whether each test was appropriate based on the recommendations for preoperative testing from our Department of Anesthesiology.
Results
We included data from 130 patients. The overall prevalence of inappropriate preoperative testing was 55%. Grade of surgery and service unit significantly affected inappropriate testing (P = 0.01 and P = 0.001 respectively). The highest prevalence of inappropriate test requests was for a complete blood count (37%), and all the risk factors, including ASA class I (P = 0.015), minor operation (P < 0.001), and nonpediatric surgery unit (P < 0.001), were significantly associated with this test.
Conclusions
The prevalence of inappropriate preoperative testing was high, especially for healthy patients who underwent minor operations. Therefore, we recommend that surgical staff be educated to request laboratory tests only when indicated.