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February 1992

The Utility of Preoperative Electrocardiograms in the Ambulatory Surgical Patient

Author Affiliations

From the Department of Anesthesia, University of California, San Francisco (Dr Gold); and Department of Anesthesia (Drs Young and Kitz) and Clinical Epidemiology Unit (Ms Kinman and Drs Berlin and Schwartz), University of Pennsylvania, Philadelphia. Dr Kitz is now with the Abington Surgical Center, Willow Grove, Pa, and Dr Schwartz is now with the Leonard Davis Institute of Health Economics, Philadelphia.

Arch Intern Med. 1992;152(2):301-305. doi:10.1001/archinte.1992.00400140055013

To determine the utility of preoperative screening electrocardiograms (ECGs) among ambulatory surgery patients, we reviewed the charts of 751 consecutive adult patients who underwent ambulatory surgery. Data were collected on demographic characteristics, coexisting medical problems, American Society of Anesthesiologists physical status score, preoperative ECG results, adverse intraoperative cardiovascular events, and postoperative cardiovascular complications. In our study population of relatively healthy outpatients, preoperative ECGs were abnormal in 42.7% of patients. Age, increased physical status score, and male gender were associated with a greater incidence of abnormal preoperative ECGs. There were 12 adverse cardiovascular perioperative events among the 751 patients (1.6%), and the preoperative ECG may have been clinically useful in six of these 12 patients. Neither preoperative ECGs nor results of preoperative screening questionnaires were predictive of adverse cardiovascular perioperative events. These findings question the utility of preoperative ECGs in the ambulatory surgery setting, especially among younger, relatively healthy patients.

(Arch Intern Med. 1992;152:301-305)