Vol. 11, Issue 1 (2025)

Objective: Post-operative blood tests (POBTs) are an essential investigation after orthopaedic surgery to assess for infection, blood loss and anaemia, electrolyte imbalance, and renal function monitoring. Identifying systemic complications early will guide appropriate treatment, therefore POBTs play a crucial role in managing recovery, identifying potential complications, and ensuring optimal healing. This study demonstrates the importance of POBTs in identifying early postoperative complications. Additionally, it compares the POBT results in different settings-major trauma vs trauma vs elective. 

Method: Between March-August 2024, we conducted a prospective and retrospective observational study with 300 Trauma & Orthopaedic (T&O) patients from three different hospitals (100 from each). The type of surgery, date of POBTs and prevalence of postoperative complications were compared. Only POBT-related complications were recorded to suit the purpose of our study. The results from each hospital were compared and analysed to evaluate any significant differences. 

Results: From the 300 evaluated cases, joint replacement surgeries were the most common in the elective setting (74%) and other types of hip surgeries were more prevalent in the acute general hospital (AGH; trauma) compared to the major trauma centre (MTC). POBTs were more frequently taken on postoperative day (POD) 1 in the elective hospital (EH; 88%) compared to the other two. There was a statistically significant difference between the rate of complications in the two trauma hospitals with 20% more POBT-related complications in the AGH. The chi-square value (6.09) was greater than the critical value. With the most common complication being deranged electrolytes, the AGH had more than twice the number of dyselectrolytaemia cases than the MTC. 25 (43%) of the dyselectrolytaemia cases were novel cases that emerged postoperatively. 

Conclusions: Differences of importance were noted between the hospital data. The overall POBT-related complication rate in our study was 31.6% with the AGH in the lead. Dyselectrolytaemia, especially hyponatraemia, was the most common type of complication witnessed in all three hospital settings. The differences in the patient cohorts of the two trauma centres contributed significantly to the postoperative period. Further research is required to look at the contributory factors resulting in this contrast.