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Related Experiment Videos

Is routine pre-operative electrocardiogram necessary?

T Yipintsoi, P Vasinanukorn, P Sanguanchua

    Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
    |January 1, 1989
    PubMed
    Summary

    Routine preoperative electrocardiograms (ECGs) in Thailand revealed significant abnormalities in 14% of patients, yet few received follow-up care. This highlights limited clinical utility of preoperative ECGs in resource-constrained settings.

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    Area of Science:

    • Cardiology
    • Public Health
    • Health Services Research

    Background:

    • Electrocardiograms (ECGs) are commonly used for routine preoperative assessment.
    • The clinical utility of preoperative ECGs in resource-limited healthcare settings remains under-examined.
    • Ischemic heart disease is a significant concern in preoperative risk stratification.

    Purpose of the Study:

    • To evaluate the yield and clinical impact of routine preoperative electrocardiograms (ECGs).
    • To assess the follow-up management of patients with abnormal preoperative ECG findings.
    • To determine the effectiveness of preoperative ECGs in a resource-constrained hospital environment.

    Main Methods:

    • Retrospective analysis of 3,371 electrocardiograms (ECGs) performed at Hat Yai Municipal hospital in 1981.

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  • Inclusion criteria: routine preoperative investigations.
  • Data review included ECG abnormality classification and subsequent patient management.

    • Main Results:

    • A total of 3,371 ECGs were analyzed; 424 were for routine preoperative assessment.
    • 14% of ECGs showed definite abnormalities suggestive of ischemic heart disease; an additional 9% were possibly abnormal.
    • Only 22% of patients with abnormal ECGs received medical evaluation, and less than half of those had their management altered.

    Conclusions:

    • Routine preoperative ECGs in this setting identified a substantial number of potentially significant cardiac abnormalities.
    • The clinical follow-up and management alteration rates for abnormal preoperative ECGs were low.
    • The findings suggest limited usefulness of routine preoperative ECGs in health centers facing resource constraints.