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Preoperative electrocardiography: its cost-effectiveness in detecting abnormalities when a previous tracing exists
Canadian Medical Association Journal
|August 4, 1979
Summary
Routine preoperative electrocardiography shows low cost-effectiveness due to infrequent new abnormalities. It is most beneficial for older patients or those with prior abnormal electrocardiograms (ECGs).
Area of Science:
- Cardiology
- Medical Economics
- Preoperative Assessment
Background:
- Electrocardiography (ECG) is commonly used before surgery.
- The cost-effectiveness of routine preoperative ECGs is debated.
- Identifying new cardiac abnormalities can inform surgical risk.
Purpose of the Study:
- To evaluate the cost-effectiveness of routine preoperative electrocardiography.
- To determine the frequency and relevance of new ECG abnormalities.
- To identify patient subgroups who may benefit most from preoperative ECGs.
Main Methods:
- Analysis of 812 patients undergoing routine preoperative ECGs.
- Assessment of new ECG abnormalities for relevance to operative risk.
- Comparison of findings with previous ECG tracings and patient data.
Main Results:
- New ECG abnormalities, particularly relevant ones, were infrequent.
- Routine preoperative ECGs were found to have low cost-effectiveness.
- Preoperative ECGs are most indicated for patients aged 60+ or with prior abnormalities.
Conclusions:
- Routine preoperative ECGs are not cost-effective for all patients.
- Targeted ECGs for specific patient groups (elderly, prior abnormalities) are more appropriate.
- Further research is needed for improved ECG protocols and repeat ECG utility.