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The Utility of Preoperative Laboratory Testing Before Urogynecologic Surgery

Husk, Katherine, E., MD; Willis-Gray, Marcella, G., MD; Dieter, Alexis, A., MD; Wu, Jennifer, M., MD, MPH

Female Pelvic Medicine & Reconstructive Surgery: March/April 2018 - Volume 24 - Issue 2 - p 105–108
doi: 10.1097/SPV.0000000000000551
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Objectives National guidelines for preoperative laboratory testing are based on limited, low-quality evidence. The role of age as a risk factor for testing is unclear. We sought to compare the prevalence of abnormal preoperative laboratory results in older vs younger urogynecologic surgical patients.

Methods In this retrospective cohort study of women undergoing urogynecologic surgery, we compared older (age, ≥65 years) with younger (age, 50–64 years) women. Our primary outcome was the prevalence of an abnormal preoperative laboratory result.

Results We included 317 women, with 167 (52.7%) in the older cohort (ages, 65–91 years; mean, 73.3 ± 5.6 years) and 150 (47.3%) in the younger cohort (ages, 50–64 years; mean, 57.3 ± 4.1 years). Overall, 18.3% of participants had at least one abnormal preoperative laboratory, with older women more likely to have an abnormal result (28.7% vs 10.7%, P < 0.001). Compared with the younger cohort, older women had higher rates of abnormal hemoglobin (13.8% vs 6.0%, P = 0.02) and creatinine values (10.8% vs 2.7%, P = 0.005), with no significant differences for platelets (3.0% vs 1.3%, P = 0.53), sodium (3.0% vs 0.7%, P = 0.22), or potassium (6.0% vs 3.3%, P = 0.27). After adjusting for potential confounders, older age remained associated with an abnormal preoperative result (odds ratio, 3.6; 95% confidence interval, 1.9–7.1).

Conclusions In our sample, women 65 years or older had a greater than 25% chance of having an abnormal preoperative laboratory result and were at higher risk compared with younger women. Age 65 years or greater should be considered as a criterion for preoperative laboratory testing in urogynecologic patients.

In our study population of women undergoing urogynecologic surgery, women ≥ 65 years had a > 25% chance of having an abnormal preoperative lab result, and were at higher risk compared to younger women, suggesting that age ≥ 65 should be considered as a criterion for preoperative laboratory testing.

From the University of North Carolina, Chapel Hill, NC.

Correspondence: Katherine E. Husk, MD, University of North Carolina, Chapel Hill, 3032 Old Clinic Bldg, CB #7570, Chapel Hill, NC 27599. E-mail: Katherine_Husk@med.unc.edu.

The authors have declared they have no conflicts of interest. There were no sources of financial support for this research.

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