The importance of Preoperative Electrocardiogram in healthy patients above 50 years old submitted to Elective Non-Cardiac Surgical Intervention

Backgroud: Patients over the age of 50 require four folds more surgical interventions than the younger group. Guidelines recommend performing the preoperative electrocardiogram in this age group. The aim of this study was to determine the importance of preoperative ECG in patients over 50 years of age in a prospective and randomized design. Methods: We assessed 427 patients over the age of 50, without comorbidities and who underwent surgical intervention under general anesthesia. The patients were randomized 1:1 to perform the preoperative ECG or not. This information was collected from each patient: sex, age, ECG result, chest X-ray, laboratory tests, surgical risk (ASA), duration procedure, adverse events and in-hospital mortality. In-hospital morbidity and mortality in group A was compared with that in group B. An adverse event was considered to be any clinical/surgical complication that increased the length of hospital stay or death. Results: There were 23 adverse outcomes, with three deaths. We observed adverse events in male patients and in those who underwent major surgical interventions not observing any difference between the groups that did or not perform the ECG. When observing the multivariate logistic regression analysis, we can notice that the male gender and the surgical size are the independent predictors of adverse outcomes, while performing or not the ECG remains without any statistical significance. Conclusion: These findings suggest that patients over the age of 50 years, without comorbidities undergoing surgical intervention under general anesthesia, that the preoperative ECG does not add any benefit in predicting postoperative complications during the in-hospital period.