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. 2005 Mar 2;123(2):50-3.
doi: 10.1590/s1516-31802005000200003. Epub 2005 Jun 8.

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

Fábio Yoshito Ajimura  1 , Alex Silva Santos Freire Maia, Adriana Hachiya, Alexandra Sayuri Watanabe, Maria do Patrocínio Tenório Nunes, Mílton de Arruda Martins, Fábio Santana Machado
Affiliations

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

Fábio Yoshito Ajimura et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

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.

CONTEXTO E OBJETIVO:: Embora seja consenso que uma anamnese e um exame clínico devam ser realizados como parte da avaliação pré-operatória, ainda há grande controvérsia a respeito dos benefícios adicionais de exames subsidiários de rastreamento na avaliação pré-operatória. Neste estudo objetivamos determinar a porcentagem de exames subsidiários alterados em uma população que foi submetida a cirurgia não-cardíaca e correlacionamos as anormalidades observadas nestes exames com mudanças realizadas nas condutas pré-operatórias.

TIPO DE ESTUDO E LOCAL:: Estudo transversal desenvolvido em Hospital Universitário.

MÉTODOS:: 991 pacientes com mais de 40 anos, que foram submetidos a operações não-cardíacas eletivas de julho de 1997 a janeiro de 2000 foram estudados. Foram avaliados o hemograma, as dosagens séricas de sódio, potássio, uréia e creatinina, os tempos de protrombina, trombina e tromboplastina parcial ativada, o eletrocardiograma e a radiografia de tórax.

RESULTADOS:: Dentre os 957 eletrocardiogramas realizados, alguma alteração foi observada em 504 (50,9%) casos e, dentre as 646 radiografias de tórax feitas, 271 (42,0%) apresentaram alterações. As porcentagens de exames de laboratório alterados variaram de 5,1% (tempo de protrombina) a 41,0% (hematócrito). Observamos, também, um aumento na porcentagem de exames alterados em pacientes mais idosos.

CONCLUSÕES:: Embora um grande número de exames subsidiários alterados seja observado na avaliação pré-operatória, estes resultados raramente interferem na conduta dos pacientes.

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Conflict of interest statement

Conflict of interest: Not declared

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