Preoperative testing for urethroplasty is not associated with outcomes - A NSQIP study.

Preoperative testing for urethroplasty is not associated with outcomes - A NSQIP study.

Mishra Kirtishri; Avila Amanda; Mahran Amr; Raina Richa; Sidagam Vasu; Ponsky Lee E; Gonzalez Chris M; Bukavina Laura

Urology

2020

2020-02

OBJECTIVE: To assess the current practice of routine preoperative testing before urethroplasty and to determine if the results are clinically significant. METHODS: Data was obtained from the National Surgical Quality Improvement Program (NSQIP) database. We identified 1,527 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. RESULTS: A total of 8,455 individual laboratory tests were performed on 1,156 patients (average of 7 tests per patient), with only 959 labs (11.3%) showing abnormal results. Of the 1,156 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<0.001), 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=0.029), 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 /= 3, the only lab predictive of postoperative complications was an abnormal coagulation profile. CONCLUSION: Obtaining routine preoperative labs, especially in patients with ASA

Urethra; Health policy; Complications; Perioperative period; Preoperative care

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