The Need for Preoperative Laboratory Tests for Elective Surgery: A Systematic Review

Background Preoperative laboratory testing is commonly conducted before elective surgery to assess a patient's overall health and identify potential risks. However, its necessity, clinical benefit, and economic justification remain controversial. Objective To systematically review the existing literature on the need, utility, clinical relevance, and cost-effectiveness of preoperative laboratory tests for elective surgeries. Method A systematic literature search was performed in databases including PubMed, Cochrane Library, and Google Scholar for studies published between 2015 and 2024. Thirty-two studies assessing the utility, clinical relevance, and cost-effectiveness of preoperative laboratory tests for elective surgeries were included. Data were extracted and qualitatively synthesized. Results The majority of studies agree that routine testing (CBC, renal function, liver function, and coagulation tests) for low-risk patients undergoing elective surgery is unnecessary and offering little impact on surgical outcomes and significantly increasing healthcare costs. However, such tests remain essential in high-risk patients and complex surgical procedures when guided by clinical assessment. Conclusion Routine laboratory testing for all elective surgical candidates is inefficient. A selective, indication-based approach improves patient safety while reducing unnecessary healthcare expenditures.