UTILIZATION OF THE PREOPERATIVE ECG

The utilisation of the pre-operative ECG in patients undergoing routine surgery was investigated in 354 adult patients over a 2-week period. Sixty-four percent of patients had an ECG pre-operatively, An ECG was not performed in 17% of patients who, current hospital policy suggests, should have had one. In contrast, an ECG was performed in 33% of patients who, hospital policy suggests, have no need of one (all of which were normal), which represented 18% of the total number of pre-operative ECGs performed. In 62% of patients with known cardiac disease, and 44% of patients with strong risk factors for ischaemic heart disease (in the absence of known disease) the ECG was abnormal. This compares with only 7% of patients aged over 50 with no risk factors in whom the ECG was abnormal. These findings suggest that there is room for improvement in the utilisation of the pre-operative ECG, which may have cost implications.