As a part of preoperative preparation for surgeries, patients undergo ample of investigations to detect asymptomatic diseases which are not apparent on history and clinical examination. The probability of finding significant abnormalities on such “routine” investigations is small, unnecessarily increasing costs of perioperative care. We evaluated current practices, compliance with guidelines and costs of preoperative investigations

A prospective observational study carried out on patients posted for elective surgery in K S Hegde Hospital to test the extent to which guidelines are adhere to in carrying out preoperative investigation. Information regarding investigations conducted, ASA physical status, procedure performed was collected and compared to the NICE guidelines to decipher frequency of non-adherence to guidelines and the probable reasons for the same. Appropriate statistical analysis done and p value of < 0.05 was considered significant

Most of the patients belong to ASA1 (60%), and surgeries belong to grade 2. Blood sugar was the most over prescribed investigation (69%) followed by renal function tests (RFT), then complete blood count (CBC). Electrocardiography, CBC, RFT demonstrated moderate adherence (40-69%). Serum electrolytes are not part of NICE guidelines, was prescribed in nearly 70%, unnecessarily increasing the cost burden.

High proportion of patients undergo excess investigations (70%) incurring unnecessary cost for medical care. This emphasizes need for institutional guidelines for the same and sensitization of junior workforce regarding the same.

Unnecessary preoperative investigations are common and make up significant proportion of medical cost. There is an urgent need for appropriate guidelines and implementation of the same vigorously.