Routine preoperative testing in adults undergoing elective non-cardiothoracic surgery

Abstract

Introduction: The Belgian Health Care Knowledge Center (KCE) developed a guideline about routine preoperative testing in adults undergoing elective non-cardiothoracic surgery. The guideline is intended for all care providers involved in the preoperative and perioperative management (incl. anesthesiologists, surgeons, cardiologists, lung specialists, radiologists, clinical biologists, general practitioners, etc). Method: A recent English guideline published by NICE (National Institute for Health and Care Excellence) was used as a starting point and adapted to the Belgian context. Clinical questions not included in the NICE guideline were developed de novo. Results: The following tests are recommended under specific conditions: resting electrocardiogram, full blood count test, kidney function tests, haemostasis tests, urinalysis and urine culture, non-invasive cardiac stress imaging. The following tests are not routinely recommended: resting echocardiography, cardiopulmonary exercise testing, chest X-ray, polysomnography, lung function tests (including arterial blood gas analysis), glycated haemoglobin test, liver function tests, coronary CT angiography. Conclusions: This guideline supports clinicians in the choice of ad hoc preoperative testing based on the most recent evidence and specific history of their patients to ensure optimal quality and safety. Tools are provided with this guideline to improve daily usage.