centers provide an estimated glomerular filtration rate (eGFR) together with a serum creatinine. eGFR estimates renal function by eliminating the influence of body mass, gender, and age (7).
participating professional societies, including the American Society of Anesthesiologists, developed lists of five practices that are over used. The messages were targeted at both physicians and patients. The Choosing Wisely Campaign encourages ongoing dialogue among patients and physicians to eliminate unnecessary tests and procedures (17). Common low-value, overutilized tests in anesthesiology include baseline laboratory studies in healthy patients without significant systemic disease when blood loss is expected to be minimal (6). Examples of these low-value tests include a CBC, basic and comprehensive metabolic panels, and coagulation studies.
disease increases perioperative risk, a resting ECG is not a reliable screen for CAD and is a poor predictor of heart disease. Advanced age is likely the most common reason prompting a preoperative ECG. One study found that in patients 70 years and older (highest risk population), the incidence of abnormal ECG was 75.2% but the presence of ECG abnormalities was not associated with an increased risk of postoperative cardiac complications (5). In addition to clinical risk factors noted in patient history, the relative risk of the surgical procedure determines the need for a preoperative ECG. It has been demonstrated that cardiovascular morbidity and mortality is associated with the type and urgency of surgery, with an increased rate of adverse event with intermediate- to high-risk procedures (6).
TABLE 2.1 Summary of Recommendations for Supplemental Preoperative Evaluation