Appropriateness of Preoperative Screenings in Patients Undergoing Elective Gynecologic Surgery at Srinagarind Hospital, Khon Kaen University, Thailand: An observational study

Abstract

Objectives: To evaluate the appropriateness of routine preoperative screening for patients who undergoing elective major gynecologic surgery at a tertiary care university hospital, Khon Kaen Province based on the hospital guideline.Materials and Methods: This retrospective descriptive study reviewed 808 medical records of gynecologic patients undergoing elective surgery in 2014.results: The mean age of the patients was 44.2 years. Approximately 36% of patients had associated co-morbidity. Almost 90% of the patients had inappropriate screening tests. Complete blood count and chest x-ray were the two most appropriate screening test. The most inappropriate tests were urinalysis and fasting blood sugar. Patients were classified into 4 groups: 1) patients < 45 years old with no underlying conditions; 2) patients < 45 years old with at least one underlying conditions; 3) patients ≥ 45 years old with no underlying conditions and 4) patients ≥ 45 years old with at least one underlying conditions. The first group had highest rate of performing inappropriate preoperative tests with blood urea nitrogen/creatinine as the most overuse test. The costs of inappropriateness preoperative tests were 39.8% of the total costs of preoperative assessment.Conclusion: Almost 90% of the patients had inappropriate screening tests which increased the cost by about 40%. Hospital administrators should find appropriate mechanisms to reinforce doctors to strict their requests for only tests that are necessary.

Keywords

• preoperative tests
• preoperative screenings
• appropriateness
• unnecessary cost