Tohidi M, Lung T, Yen D. Routine perioperative practices and postoperative outcomes for elective lumbar laminectomies.
JOURNAL OF SPINE SURGERY 2018;
4:588-593. [PMID:
30547123 DOI:
10.21037/jss.2018.09.01]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
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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