Utility of preoperative laboratory evaluation in low-risk patients undergoing hysterectomy for benign indications

Preoperative Investigations: Practice Guidelines from the Indian Society of Anaesthesiologists

“…Literature review regarding complete blood count (CBC) revealed that some of the available studies had tested individual components of CBC, that is, haemoglobin or haematocrit, total and differential leukocyte count and platelet count, while others had tested CBC as a whole. [ 3 11 12 13 19 20 21 22 23 24 ]…”

“…Anaemia is a global health issue with a prevalence rate of approximately 14% in ASA PS 1 and 2 preoperative patients. [ 3 11 12 13 19 20 21 22 23 24 25 26 27 ] This can contribute to adverse events such as tachycardia, arrhythmias, increased risk of infection, heart failure in the perioperative period. It can also contribute to increased duration of hospital stay, rates of intensive care admission and blood transfusion, which carry their own associated risks.…”

“…Nine studies (n = 27697) tested the effects of preoperative haemoglobin/haematocrit on immediate perioperative outcomes [ Table 4 ]. [ 3 11 12 13 19 20 21 22 23 ] Most studies included combinations of minor, intermediate and major surgeries. Review of evidence indicates the need for haemoglobin testing preoperatively in patients scheduled for intermediate to major surgeries.…”

“…Both leukocytosis and leukopenia can potentially contribute to adverse outcomes in the perioperative period. Among four studies that tested TLC (n = 25817),[ 11 12 13 20 ] leukocytosis was associated with adverse outcomes in patients undergoing intermediate and major surgeries. However, leukopenia did not influence the perioperative outcomes.…”

“…Three studies (n = 24617) reported no influence on the perioperative outcome with platelet count <1.5 x 10 6 /mm 3 . [ 11 12 20 ] Increased platelet counts also can have adverse implications related to thrombotic mechanism. Three studies (n = 24617) reported no influence on the perioperative outcome with platelet count >4.5 x 10 6 /mm 3 [ Table 4 ].…”