Reconstructive urology. Preoperative testing for urethroplasty is not associated with outcomes-a NQSIP study
Title
Reconstructive urology. Preoperative testing for urethroplasty is not associated with outcomes-a NQSIP study
Creator
Mishra K; Avila A; Mahran A; Raina R; Sidagam V; Ponsky LE; Gonzalez CM; Bukavina L
Publisher
Urology
Date
2020
2020-05
Description
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 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. RESULTS 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. CONCLUSION Obtaining routine preoperative labs, especially in patients with ASA <= 2, does not affect postoperative outcomes in patients undergoing urethroplasty. (c) 2020 Elsevier Inc.
Subject
low-risk; physicians
Identifier
Rights
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Format
journalArticle
URL Address
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Pages
182–187
Volume
139
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Update Year & Number
July 2020 List
Citation
Mishra K; Avila A; Mahran A; Raina R; Sidagam V; Ponsky LE; Gonzalez CM; Bukavina L, “Reconstructive urology. Preoperative testing for urethroplasty is not associated with outcomes-a NQSIP study,” NEOMED Bibliography Database, accessed March 28, 2024, https://neomed.omeka.net/items/show/11140.