Overview of Preoperative Cardiology Consultation at a Tertiary Care Centre

  • S. Thapa Department of Internal Medicine, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal https://orcid.org/0000-0002-7671-059X
  • M. Basnet Department of Cardiothoracic and Vascular Anesthesiology, Maharajgunj Medical college, Institute of Medicine, Kathmandu
Keywords: Consultation and referral, preoperative care, cardiology service

Abstract

Preoperative cardiac consultations are regularly performed during pre-anaesthetic checkup. However, the efficiency and usefulness of these consultations are unclear. The objective of this study is to assess the indication and usefulness of preoperative cardiac consultation. In this cross sectional study, 100 patients sent for preoperative cardiac consultation were evaluated. Baseline characteristics, Revised Cardiac Risk Index (RCRI), comorbidities were recorded. The motive for referral and outcome of the consultation were evaluated. Evaluated patients consist of male (45%) and female (55%) with age ranging from 18 to 89 years (average 51.28 ± 14.6 years). Most common co morbidities were hypertension (53%) and diabetes (30%). High proportion (49%) of patients we resent for cardiac consultation with suspicion of abnormal ECG. Most of the patient had RCRI of 0 and1 (45% and 28% respectively), while 14% and 13% had RCRI of 2 and 3 respectively. “Clearance for surgery” was the most common reason for consultation (60%) followed by risk stratification (41%) and optimization of cardiac disease (40%). Twenty four percent of patients were sent with suspicion of cardiac co morbidity. Twenty six percent were sent without any specific cause. Only 27% of the patient had increased risk of major adverse cardiac events. Further management was not needed in 58% patients. Only 12% patients had a new diagnosis. Preoperative cardiac consultation can be useful in detecting newer cardiac comorbidities and optimization in some patients. However, most preoperative cardiac consultation does not alter the perioperative management

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Abstract
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Published
2019-11-24
Section
Original Articles