Gold B S, Young M L, Kinman J L, Kitz D S, Berlin J, Schwartz J S
Department of Anesthesia, University of California, San Francisco.
Arch Intern Med. 1992 Feb;152(2):301-5.
To determine the utility of preoperative screening electrocardiograms (ECGs) among ambulatory surgery patients, we reviewed the charts of 751 consecutive adult patients who underwent ambulatory surgery. Data were collected on demographic characteristics, coexisting medical problems, American Society of Anesthesiologists physical status score, preoperative ECG results, adverse intraoperative cardiovascular events, and postoperative cardiovascular complications. In our study population of relatively healthy outpatients, preoperative ECGs were abnormal in 42.7% of patients. Age, increased physical status score, and male gender were associated with a greater incidence of abnormal preoperative ECGs. There were 12 adverse cardiovascular perioperative events among the 751 patients (1.6%), and the preoperative ECG may have been clinically useful in six of these 12 patients. Neither preoperative ECGs nor results of preoperative screening questionnaires were predictive of adverse cardiovascular perioperative events. These findings question the utility of preoperative ECGs in the ambulatory surgery setting, especially among younger, relatively healthy patients.
为了确定术前筛查心电图（ECG）在门诊手术患者中的作用，我们回顾了751例连续接受门诊手术的成年患者的病历。收集了有关人口统计学特征、并存的医疗问题、美国麻醉医师协会身体状况评分、术前心电图结果、术中不良心血管事件以及术后心血管并发症的数据。在我们相对健康的门诊患者研究人群中，42.7%的患者术前心电图异常。年龄、身体状况评分增加和男性与术前心电图异常的发生率较高相关。751例患者中有12例围手术期发生不良心血管事件（1.6%），术前心电图可能对这12例患者中的6例具有临床意义。术前心电图和术前筛查问卷结果均不能预测围手术期不良心血管事件。这些发现质疑了术前心电图在门诊手术中的作用，尤其是在较年轻、相对健康的患者中。
