Are We Justified in Doing Blood Tests “Routinely” for all Preoperative Neurosurgical Patients? A Retrospective Audit of 170 Patients in a Tertiary Care Center

Aim: We conducted this study to ensure continuing patient care in a cost-effective and efficient manner among the neurosurgical patients undergoing elective spine surgery in a tertiary care center.

Objectives: The objectives of this study are to determine the clinical importance of routine preoperative bloods in patients undergoing spine surgery, the indications, and to evaluate prevalence of blood abnormality on routine blood analysis in this group of patients. An economic perspective is provided after a retrospective analysis.

Methods: In this study we included 170 patients who underwent elective spine surgery in the department of Neurosurgery at Cork University Hospital.

Results: There were 94 males and 76 females. The age range was 19 to 84 years. This study shows that, of all tests performed, between 87.4 and 100% displayed results within the normal reference range. Of the abnormal results, the majority fall close to standard reference ranges. The total cost of tests performed was €6115 and 95% of this cost was attributed to normal blood results.

Conclusion: We conclude that routine blood tests including coagulation profile is not necessary in healthy individuals undergoing elective spine surgery. These “routine” investigations not only have a negative impact on the available hospital resources but also adds economic burden to the prevailing health service. A reaudit is recommended and involvement of different surgical specialties in this audit may support our findings.