Preoperative screening electrocardiography: predictive value for postoperative cardiac complications.
The purpose of this study was to evaluate the value of preoperative electrocardiography in predicting postoperative cardiac complications. Four hundred eighty-one patients having elective surgery were eligible. The patients' ages and specific ECG findings were recorded preoperatively. The patients had prospective follow-up from admission to discharge for the development of postoperative cardiac complications. The data were analyzed using stepwise logistic regression. Postoperative ischemic events were predicted by ECG findings of ST segment abnormalities and ECG evidence of previous myocardial infarction. Age, P wave abnormalities, and preoperative dysrhythmias were independent predictors of postoperative dysrhythmic events. These specific ECG findings may identify patients at risk of postoperative ischemia or dysrhythmia. These patients may benefit from aggressive preoperative cardiac evaluation or close postoperative cardiac monitoring.
Velanovich
V
V
General Surgery Service, Ireland Army Community Hospital, Fort Knox, Ky 40121-5520.
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D017558:Elective Surgical Procedures; D004562:Electrocardiography / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000175:diagnosis*; D010808:Physical Examination; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012306:Risk