Abnormal Pre-Operative Tests, Pathologic Findings of Medical History, and Their Predictive Value for Perioperative Complications

Acta Anaesthesiol Scand. 2012 Mar;56(3):339-50. doi: 10.1111/j.1399-6576.2011.02593.x. Epub 2011 Dec 20.

Abstract

Background: Laboratory tests, electrocardiogram (ECG) and chest X-rays still serve as part of the routine assessment before elective surgery in many institutions, even though there is little evidence of their predictive value relating to perioperative complications. This study investigates the correlation of abnormal findings in pre-operative tests and pathologic findings in the medical history with perioperative complications.

Methods: Patients scheduled for elective surgery in a secondary care hospital were included in this prospective cohort study. Abnormal pre-operative tests, significant findings from the medical history and perioperative complications were recorded. Regression analysis was performed in order to identify the strongest predictors for perioperative complications.

Results: A total of 1363 (56.1% female) patients were consecutively included in this study. The percentage of abnormalities in pre-operative tests ranged from 1.6% (electrolytes) and 29.7% (echocardiography). Eighty-six (6.3%) patients had at least one perioperative complication. The most frequent complications were hypo- or hypertension in 55 cases (4.0%), followed by 20 patients (1.5%) who suffered from hemodynamically relevant cardiac dysrhythmias such as supraventricular tachycardia, ventricular tachycardia, bradycardia and ventricular extrasystoles. The binary logistic regression analysis to identify predictors of perioperative complications showed significant results for age, invasiveness of the procedure, history of renal disease or anemia and abnormal ECG.

Conclusion: Our results indicate that age, type of surgery and medical history are appropriate predictors of perioperative complications, whereas abnormalities in laboratory tests seem to have restricted ability in predicting adverse perioperative outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / physiopathology
  • Blood Transfusion / statistics & numerical data
  • Child
  • Child, Preschool
  • Cohort Studies
  • Electrocardiography
  • Female
  • Humans
  • Infant
  • Intraoperative Complications / epidemiology*
  • Likelihood Functions
  • Logistic Models
  • Male
  • Medical History Taking
  • Middle Aged
  • Perioperative Care*
  • Postoperative Complications / epidemiology*
  • Predictive Value of Tests
  • Preoperative Period*
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Surgical Procedures, Operative
  • Young Adult