Abstract
Objective:
Health care expenditures continue to rise, and there is significant pressure on clinicians to minimize costs while practicing evidence-based medicine. Postoperative laboratory testing adds significant cost to hospitals and patients, but the universal utility of such testing has yet to be addressed. This study investigated cost-effectiveness and clinical efficacy of postoperative day–1 (POD1) hemoglobin and hematocrit testing in patients who underwent urogynecologic surgery.
Materials and Methods:
This was a retrospective review of 312 charts of patients who underwent urogynecologic procedures between 2015 and 2018. Patient demographics, estimated blood loss, and pre/postoperative hemoglobin were evaluated. Patients were assessed for clinically significant outcomes, including blood transfusions or increased length of hospital stay.
Results:
A total of 312 charts were reviewed. The average patient age was 54, and the most-common procedure performed was anterior colporrhaphy. Average change in hemoglobin was 2.70 g/dL (standard deviation [SD] = 0.961). There was no correlation with hemoglobin value and blood transfusion or increase in hospital length of stay. Of 312 patients, 12 received blood transfusions—a total of 17 transfusion events. This correlated to 1.3% of patients requiring changes in management based on the results of POD1 laboratory tests. No patients received transfusions based solely on their POD1 laboratory results.
Conclusions:
Routine laboratory testing on POD1 appears unwarranted and expensive, totaling approximately $35,568 in hospital charges. With the low rate of laboratory-associated interventions, the current study suggests that routine hemoglobin studies on POD1 are not necessary, evidence-based, nor cost-effective. More studies are needed to examine complications in urogynecologic patients.
Get full access to this article
View all access options for this article.