Minimising costs in spinal surgery: is group &amp; save testing justified in lumbar decompression surgery?

Wilson, William T.; Young, Adam M. H.; Fivey, Paul

doi:10.21037/jss.2016.12.13

Cited by 1 publication

(2 citation statements)

References 10 publications

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“…We demonstrated that blood transfusion in the context of elective lumbar laminectomy is rare. Our findings are in keeping with existing literature, which suggests that given the low risk of transfusion for this procedure, it would be safe to discontinue preoperative type and screen (9,10). With respect to other bloodwork, it has been shown that neither preoperative blood testing, nor abnormal test results, are associated with postoperative complications (11).…”

Section: Discussionsupporting

confidence: 88%

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Routine perioperative practices and postoperative outcomes for elective lumbar laminectomies

2018

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Background: Routine investigations for asymptomatic patients undergoing low-risk surgery contribute little value to perioperative care, but these tests are still ordered in many centres. The primary purpose of this retrospective cohort study was to determine the prevalence of preoperative bloodwork for elective lumbar laminectomy and its association with intraoperative and postoperative complications. Secondary objectives were to determine the prevalence of intraoperative tranexamic acid administration, length of stay, and 30-day readmission. Methods: Retrospective electronic chart reviews were conducted on all patients 18+ years old who underwent elective lumbar laminectomy by one orthopaedic spine surgeon between July 01, 2013 and June 30, 2017. All procedures were performed at the University Health Sciences Centre. Results: Two hundred fifty-six patients underwent lumbar laminectomy at one or more levels during the study period. Among these patients, 89.5% underwent at least one preoperative blood test. The intraoperative complication rate was 2.34%. Intraoperative intravenous tranexamic acid was administered in <2% of surgeries; there were no postoperative blood transfusions. The 30-day hospital readmission rate was zero. Conclusions: Hospital policies should be re-evaluated to address the overuse of unnecessary preoperative investigations for elective lumbar laminectomies, which have low perioperative transfusion and complication rates.

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Section: Discussionsupporting

confidence: 88%

“…Few studies have evaluated the utility of preoperative bloodwork for elective lumbar laminectomy. The published literature to date suggests that bloodwork may be safely disregarded (9,10). Still, these investigations have been routinely ordered for patients in our facilities.…”

Section: Original Studymentioning

confidence: 99%