Validade da rotina de realização do eletrocardiograma na avaliação pré-operatória de idosos

Abstract

BACKGROUND AND OBJECTIVES: Because of medical progress, life expectancy has been prolonged and the elderly population submitted to surgical procedures has been growing. Besides age-related cardiovascular changes, the prevalence of diseases, such as systemic hypertension, affect cardiovascular reserve and increase morbidity, mortality and perioperative outcomes. Electrocardiogram is useful in diagnosing previous myocardial infarction and arrhythmias. In the preoperative evaluation of these patients, ECG usefulness is a controversial subject. This study aimed at retrospectively evaluating the validity of preoperative ECG in elderly patients. METHODS: Retropective analysis of 481 patient records over 60 years old, submitted to different surgical procedures. Data were collected for description of the studied group; evaluation of most frequent electrocardiography abnormalities; comparative analysis between patients with normal and abnormal ECG related to age, ASA physical status, presence of cardiac disease intra and postoperative complications. Patients without cardiovascular disease (CVD) and physical status ASA I were separately analyzed. RESULTS: There were 481 patients, 287 of them with preoperative ECG and from those, 88,8% had abnormalities, being the most frequent ventricular repolarization changes.There was not influence of the parameters on the frequency of abnormal ECG. The abnormalitees of the ECG, especially those secondary to ischemia were related with intraoperative complications in all study groups. CONCLUSIONS: This study has shown that electrocardiogram is a valid routine for preoperative evaluation of elderly patients.