Key result
Patients with an actionable preoperative laboratory test were 11.3 times more likely to have an actionable postoperative laboratory test following total hip or knee arthroplasty.
Why the study?
Laboratory studies are routinely obtained perioperatively for THA and TKA, but their necessity and risk factors for laboratory-associated interventions remain to be evaluated.
Are routine perioperative laboratory tests necessary for all patients undergoing total hip and knee arthroplasty?
Observational (n=967)
No
Are routine perioperative laboratory tests necessary for all patients undergoing total hip and knee arthroplasty?
Relative Risk: 11.3
Routine perioperative laboratory tests may not be necessary for all patients undergoing total hip or knee arthroplasty, as preoperative lab results strongly predict the need for postoperative testing.
May inform selective postoperative testing after abnormal preoperative labs in arthroplasty; leaves open prospective validation of outcomes.
BACKGROUND: Laboratory studies are routinely obtained preoperatively and postoperatively for total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study evaluates the necessity of routine, perioperative laboratory tests and identifies risk factors for laboratory-associated interventions. METHODS: This retrospective review evaluated 967 consecutive patients scheduled for primary, unilateral TKAs (n = 593) or THAs (n = 374) over an 18-month period at a single institution. Preoperative prothrombin time (PT) and International Normalized Ratio (INR), complete blood count (CBC), complete metabolic panel (CMP), and postoperative CBC and basic metabolic panel (BMP) were recorded along with any laboratory-associated intervention. Patient demographics and comorbidities identified risk factors for abnormal or actionable laboratory studies. RESULTS: = .030) were risk factors for an actionable CBC. There were no risk factors for an actionable BMP. Patients with an abnormal preoperative lab were 2.4 times more likely to have an actionable postoperative lab. Patients with an actionable preoperative lab were 11.3 times more likely to have an actionable postoperative lab. CONCLUSION: Routine preoperative and postoperative labs may not be necessary on all patients undergoing a TKA or THA. Comorbid risk factors and abnormal or actionable preoperative CMPs and CBCs can help determine the usefulness of postoperative laboratory assessments.
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Angerame et al. (2021) conducted an observational in Total hip and knee arthroplasty (n=967). Actionable preoperative laboratory tests vs. Normal preoperative laboratory tests was evaluated on Actionable postoperative laboratory test (RR 11.3). Patients with an actionable preoperative laboratory test were 11.3 times more likely to have an actionable postoperative laboratory test following total hip or knee arthroplasty.
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