Routine Preoperative Hematocrit Testing in Adults Presenting for Day Case Surgery: is It Necessary in A Developing Environment

Background: Preoperative hematocrit estimation has been one of the basic routine requirements before an anaesthetic is administered. Non availability of hematocrit result or a value less than 30% often led to cancellation of an elective surgery by the anaesthetist. Objective: The aim of the study was to determine the prevalence of anemia among adult patients presenting for day case surgery in two Nigerian Tertiary Hospitals. Patients and method: The hematocrit levels of patients, 16 years or above, who presented for ambulatory surgery at two tertiary healthcare facilities in Southern Nigeria over a three year period were retrospectively examined for prevalence of anemia. The data was extracted from anesthetic records. Anemia was taken as hematocrit level of less than 30%. Results: A total of 423 patients had their surgeries done on day case basis during the period. There were 245 females and 178 males. There was no significant difference between the mean hematocrit of the males (40.99%) and that of the females (36.56%) (P >0.9). Age showed significant correlation with the hematocrit decreasing with age in males (P =0.002) and increasing with age in the females (P= 0.048). The overall prevalence of anemia was 2.6%. Conclusion: Preoperative anemia in Nigerian adult patients presenting for day case surgery showed a low prevalence. Preoperative hematocrit evaluation in healthy adult patient presenting for day case surgery should be based on clinical findings, the magnitude of contemplated surgery and anticipated blood loss rather than as a routine.