Intercurrent medical diseases: incidence and effects on the course of anaesthesia in a tertiary hospital.

OBJECTIVE

A prospective study was carried out to determine the incidence of intercurrent medical diseases and peri-operative course of such patients presenting for surgery under anaesthesia at the University of Benin Teaching Hospital, Benin City, for a period of twelve months.(March 2002 - February 2003).

METHODS

All patients presenting for surgery at our general modular operating rooms formed the subjects for this study. A standardized form was used to document patients characteristics, presence of medical diseases, level of control, indication for surgery, type of anaesthesia, perioperative complications and outcome.

RESULTS

Five hundred patients had surgery under anaesthesia. Our data showed incidence of intercurrent medical diseases (IMD) to be 19.6% . The prevalent age of intercurrent medical diseases was 60 years and above. The incidence of common illnesses was: hypertension (41.86% ), diabetes (14.2% ), upper respiratory tract infection (11.22% ), obesity (9% ) and anaemia (6.1% ). The most frequent observed intraoperative complications in patients with IMD were cardiovascular (hypertension-19.04% , bradycardia-19.04% , hypotension- 14.29% and tachycardia-14.29% . In recovery room, the common documented complications were hypertension-30% , tachycardia-22.5% , hypotension- 12.5% and prolonged unconsciousness-10% . The incidence of perioperative adverse events was higher in patients with IMD than in those without IMD. It was extremely significant. (P=0.0006; Odds ratio=0.5115; 95% CI: 0.3510 - 0.7455 using the approximation of Woolf). Patients aged over 60 years were more likely to present for surgical treatment with intercurrent medical conditions. (p < 0.0001, Odds ratio=0.03843, 95% CI: 0.2141 - 0.06900).

CONCLUSIONS

Intercurrent medical disease was commonly found in patients above 60years and is a predictor of both intraoperative and postoperative adverse events.