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

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Authors: Mishra, K; Avila, A; Mahran, A; Raina, R; Sidagam, V; Ponsky, LE; Gonzalez, CM; Bukavina, L
Article Title: Preoperative Testing for Urethroplasty is Not Associated With Outcomes-A NSQIP Study.
Abstract: 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.
Journal Title: Urology
ISSN: 1527-9995; 0090-4295
Publisher: Elsevier Inc  
Date Published: 2020