Background
To assess the clinical implications of the use of non-fasting rather than fasting blood tests before elective orthopedic surgery and to contribute to the fast-track surgery.
Method
We studied 305 patients (aged 18-83 years) who underwent elective orthopedic surgery at the orthopedic center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Fresh blood samples were obtained from 151 individuals who had fasted (fasting>8 h) and from 154 individuals who had not fasted. Standard hospital assays were used on all samples to measure the complete blood count (CBC, leukocyte (WBC), hemoglobin (HGB), platelet (PLT)), basic blood chemistry tests (serum sodium (Na), serum potassium (K), serum chlorine (Cl), blood calcium (Ca)), inflammatory markers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)), coagulation function tests(prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), plasma fibrinogen (PFIB)), liver function tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT)), and kidney function tests (creatinine (CRE), urea nitrogen (BUN)). Besides, we also analyzed the average length of stay and the cost of inpatient care between two groups in our departments.
Results
The results of the complete blood count (CBC), basic blood chemistry tests (Na, K, Cl, Ca), inflammatory markers (CRP, ESR), coagulation function tests (PT, INR, APTT, FIB), liver function tests (AST, ALT), and kidney function tests (CRE, BUN) were not significantly different between the fasting and non-fasting groups (P>0.05). However, the blood glucose levels in the non-fasting group were 0.4 mmol/L greater than those in the fasting group. The average hospital days were decreased from 7.5 days to 6.5 days while the cost of inpatient care was reduced approximately 10%.
Conclusions
Our study recommends the routine use of non-fasting blood tests before elective orthopedic surgery which is helpful in implementing the fast-track surgery.