Examens complémentaires pré-interventionnels en chirurgie programmée : il est temps d’évaluer nos prescriptions systématiques !

Background: The prescription of preoperative complementary tests aims to decrease morbidity and mortality associated to the perioperative period. Aim: To assess the practice and the financial cost of the systematic prescription of preoperative tests. Methods: This was a retrospective study including all patients older than three years, scheduled for elective surgery from November 2018 to January 2019. Two attendings analyzed the data collected during the pre-anesthetic assessment and evaluated the usefulness of the ordered preoperative tests. The overall cost of prescribed preoperative tests and the cost generated by inappropriate prescriptions were also estimated. Results: This study included 1006 patients. The average age was 46.9 ± 22.05 years old. Five hundred and twenty threeof them (51.98%) have no medical history. Among the planned procedures, 6.46% had an intermediate or major bleeding risk. Preoperative prescriptions were ordered by surgeons in 99% of cases. Prescriptions were justifiable in only 9.42% of cases. Abnormal findings were noted in 4.98% of the patients. The total cost was almost 80992 Dinars (≈ 24543 €). Complying the guidelines would save 70245 Dinars (≈ 21286 €) during the three months’ study. Conclusion: The routine prescription of preoperative complementary tests results in a significant additional economic cost. Developing national guidelines would change this attitude of unnecessary prescription.