The Incidence of Abnormal Preoperative Testing Among Elective Surgery Patients in a Referral Hospital in Southern Saudi Arabia

Background Preoperative investigations are important to assess the clinical condition of patients who undergo elective surgical procedures. However, there is still debate about the usefulness of performing preoperative investigations. We aimed to determine the prevalence of routine preoperative investigation abnormalities among elective general surgery patients. Methodology This retrospective hospital-record-based study was conducted at the King Abdullah Hospital in Bisha Province, southern Saudi Arabia. General and clinical data of 968 patients who underwent elective surgical interventions from February 2022 to January 2023 were retrieved and analyzed. Result A total of 968 patients (578 females and 390 males) aged between 14 and 80 years were included in the study. Four hundred and eleven (42.5%) patients were in the age group of 40 years and above. The commonly detected comorbidities among the patients were diabetes (15%), hypertension (12%), respiratory diseases (7.5%), and cardiac diseases (2.5%). Abnormalities related to hemoglobin (31%), total leucocyte count (12.7%), and platelets (8.5%) were found in 968 patients. Around 15% of patients had increased creatinine levels. Hypokalemia was observed in 6.8% of patients. Increased liver enzymes were reported in limited proportions (10% to 14%) of patients. Slightly abnormal radiological findings were reported for chest X-ray (CXR) (2.8%), electrocardiogram (ECG) (2%), and Doppler echocardiography (Echo) (0.8%). A statistically significant association between the age of the patient and abnormal findings of ECG (p <.001), Echo (p = .001), and CXR (p <.001). Cardiac abnormalities were commonly associated with patients of ≥ 40 years. Abnormal cardiac findings (CXR, ECG, Echo) were significantly (p<.05) increased with the presence of diabetes, hypertension, and cardiovascular comorbidities. Conclusions Preoperative testing revealed limited proportions of abnormal findings among patients with elective surgical procedures. Routine ordering of many preoperative investigations without specifications may not predict postoperative complications of the patients. Therefore, undertaking preoperative testing should be guided by targeted history, physical examination, clinical risk factors, and type of surgical procedure intended to be performed.

Prevalence and Risk Factors of Renal Stones Among the Bisha Population, Saudi Arabia

BACKGROUND

In urolithiasis, urinary calculi are formed in the urinary system. Stone development does not initially result in any symptoms, but later renal colic, flank pain, hematuria, obstruction of urine flow, and/or hydronephrosis may indicate renal stone disease. In addition to age, gender, ethnicity, and local climate, urolithiasis can be caused by several other factors. The prevalence and recurrence rate of kidney stone disease is rising globally, while few effective treatment options currently exist.

METHODS

Between June and October 2022, a cross-sectional study was conducted. An electronic questionnaire subdivided into three categories was used to determine the prevalence and identify the factors that increase the likelihood of developing urolithiasis among the population in Bisha. The collected data were reviewed and analyzed via IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

RESULTS

A total of 1,002 participants filled out the questionnaire. The age of the participants ranged from 18 to over 60 years, with an average age of 26.1 ± 13.9 years. There were 451 female participants (45%), and 927 (92.5%) were Saudis. According to the participants' body mass index, 98 (9.8%) were underweight, 388 (38.7%) were normal weight, 300 (29.9%) were overweight, and 216 (21.6%) were obese. The total number of participants with urolithiasis was 161 (16.1%), and 420 (41.9%) had a family history of renal stones. Urolithiasis was found to be significantly associated with family history, smoking, diabetes, hypertension, hyperthyroidism, gout, and chronic kidney disease. Older age and female gender were also associated with the risk of having urolithiasis.

CONCLUSION

This study found urolithiasis to be highly prevalent among the Bisha population. In terms of risk factors, body mass index, smoking, and diabetes were the most significant. Based on the findings of this study, the authors recommend more public education regarding urolithiasis and its risk factors, emphasizing the importance of preventing the disease and the ways of treating urolithiasis through medical campaigns and social media.