Preoperative laboratory testing in elderly patients

Abstract

Purpose of review Preoperative testing in elderly patients is performed to examine the patient's current medical condition in the context of evaluating vulnerabilities and predicting postoperative complications to ensure that all functions recover before surgery. This review focused on preoperative laboratory tests in geriatric patients. Recent findings Preoperative complete blood count, electrolyte testing, and blood chemistry can predict postoperative complications. Preoperative elevated morning/evening salivary cortisol secretion ratio, C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratios, and preoperative decreased serum albumin level or 25-hydroxyvitamin D levels can predict postoperative cognitive dysfunction. Elevated brain-type natriuretic peptide or serum alkaline phosphatase levels can be biomarkers of major postoperative adverse cardiac events. Decreased preoperative estimated glomerular filtration rates and serum albumin levels can predict acute kidney injury. Hyponatremia, hypocalcemia, and low albumin/fibrinogen ratio predict postoperative complications. Hypoalbuminemia can predict surgical site infection or postoperative mortality after hip fracture surgery. A high CAR can predict anastomotic site leakage and is a risk factor for one-year mortality after hip surgery. Summary Preoperative laboratory testing helps predict postoperative adverse complications; thus, a plan of care can be initiated.

Low serum calcium is associated with perioperative blood loss and transfusion rate in elderly patients with hip fracture: a retrospective study

“…Similarly, almost 27.72% of hospital patients may experience hypocalcemia, and the incidence was the highest in patients over 65 years [ 31 ]. Regarding the harm of hypocalcemia, a recent review summarized the relationships between preoperative hypocalcemia and postoperative adverse complications in elderly patients [ 32 ], and another systematic review found admission hypocalcemia was associated with increased mortality in trauma patients [ 18 ]. These findings suggest that clinicians should pay attention to hypocalcemia because of life-threatening consequence [ 31 ].…”

İç Hastaliklari Yoğun Bakim Üni̇tesi̇nde Taki̇p Edi̇len Geri̇atri̇k Hastalarda Serum Üri̇k Asi̇t Düzeyi̇ İle Erken Dönem Mortali̇te Arasindaki̇ İli̇şki̇

“…Vakumlu jelli tüplere alınan kan örnekleri (1500 g' de (28). Geriatrik hastalarla yürütülmüş olan bir çalışmada preoperatif hipoalbumineminin operasyon sonrası 1 yıllık izlemde artmış mortalite oranı ile birlikte olduğu gösterilmiştir (29) Acil serviste geriatrik hastalarla yürütülmüş olan bir başka çalışmada da nötrofil/lenfosit oranı ve CRP/albumin oranının bu hasta grubu için mortalite belirleyicisi olabileceği öne sürülmüştür (30) Biz de çalışmamızda hem ABH olan olgularda hem de erken kaybedilen olgularımızda belirgin albümin düşüklüğünün olduğunu gözlemledik. Çalışma sonuçlarına dayanarak yaşlı yoğun bakım hastaları için serum albümin seviyesinin erken dönem mortalitesini ön görmede etkin, kolay ve ulaşılabilir bir parametre olabileceğini söyleyebiliriz.…”