Perioperative medicine & outcomes
Preoperative test requests for elective surgeries of different complexity: Appropriateness and interhospital variability
Authors' conclusion
Inappropriateness of preoperative test requests was high according to hospital protocols and especially high according to the NICE guidelines.
Study context
- Population
- Adults (>18 y) undergoing elective cataract surgery, inguinal hernia, laparoscopic cholecystectomy, colon surgery or primary knee replacement in 9 Spanish National Health System hospitals, 5 working days in June 2022
- Participants
- 1,522 adults · 9 hospitals
- Outcome
- Appropriateness of requested preoperative tests according to hospital protocols and NICE guidelines
Methodological detailsretrospective, multicentre, observational, random-intercept multilevel models
- Retrospective
- Multicentre
- Observational
- Random-intercept multilevel models
Main finding
As reported in the abstract
Preoperative test request inappropriateness
Inappropriateness according to hospital protocols
12.03 %
Inappropriateness according to NICE guidelines
72.99 %
Observational data: associations, not effects.
Further findings
Independent factors determining inappropriateness
- Hospital-level: center complexity and availability of computerized preoperative request templates
- Patient-level: age, ASA grades and surgical complexity
Hospital protocol criteria vs NICE recommendations
- Protocol criteria varied notably between hospitals; most protocols showed low agreement with NICE, especially for over-requested tests
Original publication
Preoperative test requests for elective surgeries of different complexity: Appropriateness and interhospital variability. J Clin Anesth. Published 16 October 2025. doi:10.
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