Prevalence of abnormal findings on routine pre-operative electrocardiogram- a multicenter study

Abstract

Adult Patients are usually required to have routine preoperative electrocardiogram(ECG), prior to major elective surgery in our practice. This is aimed at detecting cardiac ECG abnormalities that may contribute to peri-operative morbidity and mortality. There is paucity of literature on this subject among Nigerian population. The multicenter study was aimed at describing the prevalence of abnormal findings on routine pre-op ECG in our patients population. Two hundred and thirty adults patients consisting of 66 males and 164 females, were referred for routine pre-op ECG in Lasuth and Luth respectively,and had their ECG tracing subsequently analyzed for the presence of ECG abnormalities. The results were subsequently presented in absolute numbers and percentages and subjected to chi square analysis were applicable. The significant p value was set at <0.05. The mean age of patients studied was 53.8 ± 5.2 years (range 33 to 80yrs). About a quarter- 62 (26.9%),of the patients had abnormal ECG and the most common abnormal findings were left ventricular hypertrophy (LVH) -23 patients (10%) and left axis deviation(LAD)-17patients (7.4%). Other abnormalities included myocardial ischaemic ST segment changes-8(3.5%), right bundle branch block(RBBB)-6 (2.6%),unifocal ventricular ectopics-4 (1.7%), first degree heart block-4 (1.7%), and others. Some of the patients had multiple abnormalities. Patients who were 50 years and above, were more likely to have abnormal ECG findings compared to their younger counterparts and this was statistically significant (x²=10.745, p value=0.001). Male patients were more likely to have abnormal ECG findings compared to their female counterparts (37.8% vs. 22.5%). The present study showed that about a quarter of routine pre-operative ECG had abnormal findings. Most of the pre-operative ECG abnormalities were benign in nature and were unlikely to influence the course of surgery.

Keywords: Routine pre-op electrocardiogram(ECG), Elective surgery