Abstract
Introduction: Electrocardiograph (ECG) is an important screening tool used to identify significant ECG changes that may alter perioperative management. Objective: To find out the pattern of ECG changes in the elderly urology patients during the pre-operative review in a tertiary centre. Study design and method: This was a prospective study of elderly urology patients recruited consecutively at the urology clinic during the pre anaesthetic review over a period of one year. Result: ECG recordings from 60 elderly patients with age ranged 65-87 years and mean age 70.84 ± 5.58 years were studied. Thirty percent of patients had normal ECG while 70% had abnormal ECG. Hypertension and diabetes mellitus were the two common intercurrent medical diseases in this study. The abnormal ECG findings were left ventricular hypertrophy 20%, sinus tachycardia 10%, sinus bradycardia 5%, left axis deviation 6.6%, right bundle branch block 6.6%, left bundle branch block 1.7%, AV block 1.7%, atrial fibrillation 3.3%, premature ventricular contraction 6.6% and left atrial enlargement 3.3% and ST elevation 5%. Conclusion: Majority of elderly presenting for preoperative assessment for urological procedures had abnormal ECG; left ventricular hypertrophy was the commonest. ECG is a readily available vital diagnostic tool for detecting patients at risk of intra and postoperative complications in a low resource centre.
Highlights
Electrocardiograph (ECG) is an important screening tool used to identify significant ECG changes that may alter perioperative management
Majority of elderly presenting for preoperative assessment for urological procedures had abnormal ECG; left ventricular hypertrophy was the commonest
This study revealed that many ECG abnormalities were found in the elderly patients coming for urological procedures, this tally with results of many authors [10,11,12]
Summary
Electrocardiograph (ECG) is an important screening tool used to identify significant ECG changes that may alter perioperative management. The incidence of peri operative complication is much higher in the elderly due to reduced functional reserve and high incidence of co-morbidities [2]. The pre-operative review for the geriatric is more complicated than in the younger population, this complexity results from the increasing number of co morbidities, various medications, poor nutrition, impaired functional status and from the detrimental impact of ageing on the physiology function [4]. For the cardiovascular system, ageing is related to a wide variety of structural and functional changes in heart and vessels. In addition to age-related physiological changes, there is increased prevalence of cardiovascular diseases (systemic hypertension, atherosclerosis, acute myocardial infarction, congestive heart failure) which further limit the functioning of this system [5]
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