Utilisation of the pre-operative ECG

Area of Science:

• Cardiology
• Perioperative Medicine
• Healthcare Management

Background:

• Pre-operative electrocardiograms (ECGs) are a standard diagnostic tool in surgical patient assessment.
• Current hospital policy guides the appropriate utilization of pre-operative ECGs.
• Variations in ECG use can impact patient management and healthcare resource allocation.

Purpose of the Study:

• To investigate the utilization patterns of pre-operative ECGs in adult patients undergoing routine surgery.
• To identify discrepancies between current practice and hospital policy regarding ECG performance.
• To analyze the diagnostic yield of pre-operative ECGs based on patient cardiac status and risk factors.

Main Methods:

• A prospective study involving 354 adult patients over a two-week period.
• Data collection on pre-operative ECG performance and adherence to hospital policy.
• Analysis of ECG results in relation to patient demographics, cardiac history, and risk factors.

Main Results:

• 64% of patients had a pre-operative ECG performed.
• 17% of patients who should have had an ECG did not, while 33% of patients who did not require an ECG received one (18% of total ECGs).
• Abnormal ECG findings were more prevalent in patients with known cardiac disease (62%) or strong ischemic heart disease risk factors (44%) compared to those over 50 with no risk factors (7%).

Conclusions:

• There is significant room for improvement in the appropriate utilization of pre-operative ECGs.
• Suboptimal ECG use may lead to unnecessary testing and missed opportunities for cardiac risk assessment.
• Optimizing pre-operative ECG protocols could have positive implications for patient outcomes and healthcare costs.