A systematic review 1 including 28 studies on chest X-ray, 16 studies on electrocardiography, 23 studies on haemoglobin, 23 studies on haemostasis, 8 studies on preoperative biochemical testing, and 11 studies on urine testing was abstracted in DARE. All included studies were case series
Findings from routine preoperative chest X-rays are reported as abnormal in 2.5-37% of cases, and they lead to change of management in 0-2.1% of cases. The limited evidence suggests that preoperative chest X-ray will be of value as a baseline measure in < 9% of cases.
Echocardiographic findings are abnormal in 4.6-31.7% of cases and lead to a change of management n 0-2.2% of cases. There was no evidence to support the value of recording a preoperative ECG as a baseline.
Haemoglobin levels may be lower than 100-105 g/l in up to 5% of patients, but rarely lower than 90 g/l. The routine test leads to change in management in 0.1-2.7% of patients.
Abnormalities of bleeding time, prothrombin time and partial thromboplastin time are abnormal in up to 3.8%, 4.8% and 15.6% of patients. The results of these tests rarely lead to change in management.
Abnormal levels of sodium or potassium are observed in up to 1.4% of patients, abnormal creatinine in up to 2.5% of patients, and abnormal levels of glucose in 5.2% of patients. The results rarely lead to change in management.
The only finding in the urine test that leads to change in management is white blood cells.
Comment: It is possible that routine testing could be of benefit in asymptomatic patients in defined groups, such as those over a given age, though there is no evidence for or against such a possibility.
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