Educational Objective: At the conclusion of this presentation, the participants should be able to understand the usefulness of preoperative laboratory testing in low risk, outpatient mastoidectomy patients.
Objectives: The objective of this study is to examine the patterns of preoperative laboratory tests (PLTs) in low risk patients undergoing ambulatory mastoidectomy and to assess their effects on postoperative complications. Study Design: Retrospective database study.
Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2005-2018 was used. Low risk patients were determined to be ASA class 1 or 2. PLTs were separated into chemistry, hematology, coagulation, and liver function tests. Univariate analysis was performed using Pearson chi square and Fisher's exact test. Binary logistic regression was performed to determine the independent effects of covariates on post-surgical complications.
Results: 2,357 patients satisfied the inclusion criteria, of which 1,058 patients (44.9%) underwent at least 1 PLT. The most frequent PLT was a complete blood cell count (76.7%). Patients who were 16 to 40 years of age (p < 0.001), male (p < 0.001), Black (p < 0.001), and hypertensive requiring medication (p < 0.001) were more likely to receive PLTs. Major complications occurred in 2.2% of patients. There was no significant difference in rates of superficial (p=0.480) or deep (p=0.505) incisional surgical site infection, wound disruption (p=0.332), urinary tract infection (p=0.505), sepsis (p=0.449), return to the operating room (p=0.745), or unplanned readmissions (p=0.496) in patients with or without PLTs. However, on multivariate analysis, patients who underwent coagulation studies had decreased risk of overall postoperative complications (OR 0.116, 95% CI 0.015-0.88, p=0.038).
Conclusions: Our study demonstrates that only patients with coagulation studies were at decreased risk of complications following ambulatory mastoidectomy procedures.