Document Detail


One-year experience with day-of-surgery pregnancy testing before elective orthopedic procedures.
MedLine Citation:
PMID:  18349183     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elective surgery is generally postponed in pregnancy. A policy of testing for urine human chorionic gonadotropin (hCG) in all women of childbearing age on the day of surgery was initiated at an elective orthopedic surgery facility. This is a retrospective report of our 1 yr experience and the associated costs. METHODS: Records were reviewed from January 3, 2005, through January 2, 2006, to determine the number of urine hCG tests performed, and the disposition of all patients with a positive result. Costs were calculated using the charges for testing supplies and laboratory labor. RESULTS: During the first year of policy implementation, 2588 of 2595 women of childbearing age underwent urine hCG testing. Five patients had a positive result, and surgery was cancelled. Of these five, three were previously unrecognized pregnancies, one an unrecognized asymptomatic ectopic pregnancy, and one a false-positive result in a perimenopausal woman. Three other women had a "weak positive" urine result, followed by a negative serum hCG. Surgery proceeded in all three. The calculated cost was $5.03 per urine test, and $3273 for each true positive result. CONCLUSIONS: A policy of routinely performing urine hCG pregnancy tests in women of childbearing age on the day of surgery was effective in detecting unrecognized pregnancy. This resulted in a postponement of elective surgery in all cases. Of 2588 women tested, one had surgery postponed because of a false-positive result. The cost of $3273 per true positive test must be compared with the benefit.
Authors:
Richard L Kahn; Maureen A Stanton; Sarani Tong-Ngork; Gregory A Liguori; Chris R Edmonds; David S Levine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  106     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-19     Completed Date:  2008-04-25     Revised Date:  2009-12-28    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1127-31, table of contents     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th St., New York, NY 10021, USA. kahnr@hss.edu
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MeSH Terms
Descriptor/Qualifier:
Chorionic Gonadotropin / urine
False Positive Reactions
Female
Humans
Menopause
Orthopedic Procedures*
Pregnancy
Pregnancy Tests / methods*
Retrospective Studies
Surgical Procedures, Elective*
Time Factors
Treatment Refusal / statistics & numerical data
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin
Comments/Corrections
Comment In:
Anesth Analg. 2010 Jan;110(1):256-7; author reply 257   [PMID:  20023186 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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