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[Indications for electrocardiogram in the preoperative assessment for programmed surgery]
F J García-Miguel1, J García Caballero, J A Gómez de Caso-Canto
1Servicio de Anestesiología y Reanimación, Hospital General de Segovia. fgarcia@hgse.insalud.es
Revista Espanola De Anestesiologia Y Reanimacion
|March 20, 2002
Summary
Screening electrocardiograms (ECGs) are recommended for patients over 40 with cardiac or respiratory conditions before surgery. Routine ECGs revealed anomalies in nearly half of patients, but rarely altered management or prevented complications.
Area of Science:
- Cardiology
- Anesthesiology
- Perioperative Medicine
Context:
- Preoperative screening is crucial for surgical risk assessment.
- The utility of routine electrocardiograms (ECGs) in asymptomatic patients undergoing non-cardiac surgery is debated.
- Understanding ECG anomaly prevalence and impact is vital for optimizing patient care.
Purpose:
- To determine appropriate indications for preoperative screening ECGs.
- To assess the prevalence and significance of ECG abnormalities in surgical patients.
- To evaluate the impact of routine ECG findings on anesthetic and surgical management and perioperative outcomes.
Summary:
- A prospective study of 413 patients undergoing non-cardiac surgery found ECG anomalies in 41.9%, with 28.6% considered major.
- Prevalence was higher in men over 40 with pre-existing heart or respiratory disease (ASA III-V).
- Unexpected anomalies occurred in 8.9% but rarely changed management (0.5%) or prevented complications (intraoperative 7.9%, postoperative 24.6%).
Impact:
- Findings suggest selective ECG screening for patients over 40 with cardiac/respiratory symptoms or disease.
- Routine ECGs in this cohort had limited impact on immediate surgical management or complication rates.
- Optimizing preoperative ECG indications can improve resource allocation and focus on high-risk individuals.