title: Detection of comorbid illnesses during pre-anaesthesia evaluation in a university teaching hospital: A prospective observational study.
abstract: BACKGROUND
  Consultation for surgery and anaesthesia is often the first point of contact with a healthcare provider for a majority of patients in developing countries. In India, where patients have poor access to healthcare, they are likely to present with uncontrolled/untreated/undetected coexisting diseases. However, there is little published literature on this aspect. We hypothesized that many of our patients will present to our pre-anaesthesia evaluation clinic (PAC) with undetected comorbid illnesses and will require proper assessment, treatment and optimization before surgery. Thus, we aimed to assess the frequency and type of comorbid illnesses in patients attending the pre-anaesthesia clinic for elective surgery.
  
  
  METHODS
  We did a prospective observational study on all patients evaluated in the PAC of our university teaching hospital over a 3-month period to assess the frequency and type of comorbid illnesses. The data recorded included demographic profile and presence of coexisting illness and was classified as preexisting or newly diagnosed at the time of the visit to the PAC. The data were then tabulated and analysed statistically using SPSS software version 14.0. The frequency and percentage of occurrence for each comorbid illness was determined.
  
  
  RESULTS
  Of 3973 patients, 242 (6%) had 304 comorbid illnesses (135 cardiac, 54 endocrine, 15 respiratory, 12 others). Of these 88 (29%) were newly detected comorbid conditions (69 cardiac, 9 endocrine, 9 respiratory, 1 others). The most frequent comorbid illness both pre-existing and newly diagnosed were cardiac. Hypertension was the commonest problem in our study population (168 patients).
  
  
  CONCLUSIONS
  We confirmed that a PAC can detect hitherto undetected comorbid illnesses which are likely to impact the perioperative process.
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India.
authors.forename: Zainab A
authors.initials: ZA
authors.lastname: Haq
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Murthy
authors.affiliation: Department of Anaesthesiology and Critical Care Max Super Speciality Hospital, Saket, New Delhi, India.
authors.forename: Indira
authors.initials: I
authors.lastname: Malik
authors.affiliation: Department of Anaesthesiology and Critical Care.
authors.forename: Vikram U
authors.initials: VU
authors.lastname: Lahori
authors.affiliation: University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Chaudhary
authors.affiliation: Department of Anaesthesiology and Critical Care G.B. Pant Hospital, New Delhi 110002, India.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Ahuja
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000776:Anesthesiology; D002648:Child; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D007037:Hypothyroidism / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology; D011300:Preoperative Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult