Preoperative laboratory testing among low-risk patients prior to elective ambulatory endocrine surgeries: A review of the 2015-2018 NSQIP cohorts

Am J Surg. 2021 Sep;222(3):554-561. doi: 10.1016/j.amjsurg.2021.01.001. Epub 2021 Jan 7.

Abstract

Background: Preoperative laboratory tests (PLTs) are not associated with complications among healthy patients in various ambulatory procedures. This association has not been studied in ambulatory endocrine surgery.

Methods: The 2015-2018 NSQIP datasets were queried for elective outpatient thyroid and parathyroid procedures in ASA class 1 and 2 patients. Outcomes were compared between those with and without PLTs. Multivariate regression examined factors predictive of receiving PLTs. Testing costs were calculated.

Results: 58.7% of the cohort received PLTs. There were no differences in outcomes between those who were and those who were not tested. Non-white ethnicity, dyspnea, and non-general anesthesia were strongly predictive of receiving PLTs. Over $2.6 million is spent annually on PLTs in this population.

Conclusions: Over half of healthy patients undergoing elective thyroid and parathyroid surgery receive PLTs. Complication rates did not differ between those with and without PLTs. Preoperative testing should be used more judiciously in these patients, which may lead to cost savings.

Keywords: Cost; Endocrine; Parathyroid; Preoperative testing; Thyroid.

MeSH terms

  • Ambulatory Surgical Procedures*
  • Clinical Laboratory Techniques / economics*
  • Clinical Laboratory Techniques / statistics & numerical data
  • Cohort Studies
  • Cost Savings
  • Costs and Cost Analysis
  • Databases, Factual
  • Elective Surgical Procedures*
  • Endocrine Surgical Procedures*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parathyroidectomy
  • Preoperative Care / economics*
  • Preoperative Care / statistics & numerical data
  • Quality Improvement
  • Regression Analysis
  • Risk
  • Thyroidectomy
  • Treatment Outcome