Costs and benefits of routine labs in hospital patients: iatrogenic anaemia and undiagnosed acute kidney injury.

Importance: Guidelines recommend avoiding unnecessary laboratory tests to minimise risks of anaemia in hospitalised patients as well as reduce costs, but there are costs to skipping routine labs including missing acute kidney injury.

Objective: Quantify the costs and benefits of routine labs in dollar costs as well as mortality.

Evidence review: This is a retrospective analysis of 48 204 admissions at University of Kentucky Hospitals and simulates different strategies for skipping labs.

Findings: In a simplified estimate of pure dollar costs, the costs of daily labs appear to outweigh the costs of missing acute kidney injury.

Conclusions and relevance: In both dollar costs and the number of patients with mortality effects, the benefits of randomly skipping labs appear to significantly outweigh the costs, but the costs are not insignificant.