Trends in pulmonary function testing before noncardiothoracic surgery

This retrospective cohort study measured trends in pulmonary function testing before noncardiothoracic surgery and assessed whether guidelines influence these trends.

Preoperative pulmonary function tests (PFTs) assess the severity of known pulmonary disease, diagnose causes of respiratory symptoms, and may help identify patients who are at risk for postoperative pulmonary complications. While useful in selected patients, unnecessary testing is costly. Few guidelines for the appropriate use of preoperative PFTs exist, with the most recent being the April 2006 American College of Physicians guidelines on risk assessment and prevention of postoperative pulmonary complications. We conducted a population-based study in Ontario, Canada, to describe temporal trends in preoperative PFTs and to assess whether the guidelines influenced these trends.