Increasing demand and financial burdens are placing significant strain on current health resources. There has been increased emphasis on improving patient flow and saving costs within the health service to help ease pressures. Routine postoperative blood tests in otherwise healthy patients may add to delays and healthcare costs without influencing subsequent management. We aimed to assess the need for routine post op blood testing in ASA 1 & 2 patients undergoing primary hip and knee arthroplasty and to assess the risk factors and intervention rate based on the post operative blood results. We conducted a retrospective review of 1595 consecutive elective hip and knee replacements in ASA 1 and ASA 2 patients in Wrightington hospital over a 1-year period from 2021–2022. Operation notes and electronic records were used to collect data. Binomial logistic regression was used to identify risk factors associated with post operative abnormalities and the need for clinical intervention. Postoperative blood abnormalities were identified in 75.4% of patients, primarily anaemia (69.2%) and hyponatremia (29.9%). Only 5% of cases required any intervention, with higher rates observed in the TKA group compared to the THA group (p = 0.008). Blood transfusion rates were low, occurring in 0.6% of cases. Although post-operative blood test abnormalities were common, the majority were mild and rarely influenced post operative management in this cohort of patients with overall low intervention rates (<5%). We conclude that selective blood testing may allow safe targeted testing in this low-risk cohort of patients minimizing costs and saving valuable resources.
Johnson et al. (Tue,) studied this question.
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