Preoperative screening: What tests are necessary?
Troy Jones, MD
J. Harry Isaacson, MDAddress reprint requests to J.H.I., Department of General Internal Medicine, A91, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
The preoperative evaluation often includes more tests than are necessary. This article reviews the usefulness of and indications for nine commonly ordered preoperative tests.KEY POINTS
Physicians must consider the history, physical findings, and type of surgery in deciding which tests are needed before surgery in the individual patient.
Patients undergoing minor surgery usually need minimal testing, even if they have established chronic medical conditions.
Excessive testing carries potential morbidity and increases the cost of medical care.
In general, coagulation testing, measurements of serum hemoglobin, potassium, creatinine, and glucose concentrations, liver function tests, urinalysis, chest radiography, and electrocardiography can be reserved for patients likely to have abnormal findings, or about to undergo surgery that may lead to abnormalities in these parameters.