Preoperative Testing for Urethroplasty is Not Associated With Outcomes-A NSQIP Study.
Adult
Aged
Databases, Factual
Female
Humans
Intraoperative Complications
/ diagnosis
Logistic Models
Male
Middle Aged
Postoperative Complications
/ diagnosis
Predictive Value of Tests
Preoperative Care
Quality Improvement
Retrospective Studies
Risk Factors
Urethral Diseases
/ complications
Urologic Surgical Procedures
/ adverse effects
Journal
Urology
ISSN: 1527-9995
Titre abrégé: Urology
Pays: United States
ID NLM: 0366151
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
19
09
2019
revised:
11
02
2020
accepted:
17
02
2020
pubmed:
29
2
2020
medline:
4
2
2022
entrez:
29
2
2020
Statut:
ppublish
Résumé
To assess the current practice of routine preoperative testing before urethroplasty and to determine if the results are clinically significant. Data was obtained from the National Surgical Quality Improvement Program (NSQIP) database. We identified 1527 patients who underwent urethroplasty from 2010 to 2017. Chi-square and one-way ANOVA tests were used to compare categorical and continuous variables, respectively. Multivariable logistic regression analyses were utilized to assess the rate of complications between testing groups. A total of 8455 individual laboratory tests were performed on 1156 patients (average of 7 tests per patient), with only 959 labs (11.3%) showing abnormal results. Of the 1156 patients, 629 (54.4%) patients had at least one abnormal lab. Patients who had at least one abnormal preoperative lab were found to be significantly older (51.49 ± 16.57 years vs 48.14 ± 16.32 years; P < .001), and to be smokers (112 [17.8%] vs 63 [12%]; P = 0.005). Additionally, they were more likely to have diabetes mellitus (112 [17.8%] vs 63 [12%]; P < 0.001), dyspnea (18 [2.9%] vs 16 [3.0%]; P = .029), and ASA class ≥3 when compared to the group with normal preoperative labs. On a multivariable logistic regression, abnormal preoperative tests were not predictive of intra- or postoperative complications in patients with ASA ≤2 (n = 1112) when adjusted for age and race. In patients with ASA class ≥3, the only lab predictive of postoperative complications was an abnormal coagulation profile. Obtaining routine preoperative labs, especially in patients with ASA ≤2, does not affect postoperative outcomes in patients undergoing urethroplasty.
Identifiants
pubmed: 32109494
pii: S0090-4295(20)30218-1
doi: 10.1016/j.urology.2020.02.018
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
182-187Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.