The role of screening blood tests in patients with arterial disease attending vascular outpatients

Objective: to evaluate the benefits of a policy of performing screening blo od tests in new patients with arterial disease referred to the vascular out patients department. Methods: clinical audit over a 12-month period of all new;referrals with ar terial disease to the vascular outpatients department at the Leicester Gene ral Hospital. Results: two hundred and seventy-two patients had at least one blood test p erformed at their outpatient visit. All of these patients had a full blood count performed, of which 21 results (21%) were abnormal. Further investiga tion of patients with abnormal results revealed one case of bladder cancer, one case of leukaemia and one patient with polycythaemia. Urea and electro lytes were measured in 269 patients (99%). Of these, 26 (10%) were expected ly abnormal in patients with known renal impairment. A further 27 patients (10%) were identified to have some degree of unrecognized renal impairment. Serum non-fasting glucose was measured in 252 patients (93%). There were 1 1 unexpectedly raised results, but further investigation of these patients only diagnosed one of these patients as diabetic. Serum cholesterol was mea sured in 201 patients (74%). One hundred and thirty-two patients (66%) had an abnormally raised serum cholesterol level. Of these, only 12 patients (6 %) were known to have hyperlipidaemia. Conclusions: screening new patients with arterial disease in vascular outpa tients does identify significant abnormalities, in particular venal impairm ent and hyperlipidaemia. Correction of these abnormalities may reduce the m orbidity associated with contrast induced nephrotoxic acute renal failure, and also contribute to secondary prevention of vascular events associated w ith raised lipids.