Preoperative Testing for Urethroplasty is Not Associated With Outcomes-A NSQIP Study.


Journal

Urology
ISSN: 1527-9995
Titre abrégé: Urology
Pays: United States
ID NLM: 0366151

Informations de publication

Date de publication:
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

182-187

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Kirtishri Mishra (K)

Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center - Urology Institute, Cleveland, OH. Electronic address: kirtishri.mishra2@uhhospitals.org.

Amanda Avila (A)

Case Western Reserve University School of Medicine, Cleveland, OH.

Amr Mahran (A)

Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center - Urology Institute, Cleveland, OH.

Richa Raina (R)

Northeast Ohio Medical University, Rootstown, OH.

Vasu Sidagam (V)

Case Western Reserve University School of Medicine, Cleveland, OH; Department of Anesthesiology & Perioperative Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH.

Lee E Ponsky (LE)

Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center - Urology Institute, Cleveland, OH.

Chris M Gonzalez (CM)

Department of Urology, Loyola University, Maywood, IL.

Laura Bukavina (L)

Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center - Urology Institute, Cleveland, OH.

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Classifications MeSH