A City Hospital Experience: Is Preoperative Internal Medicine Evaluation Important?

Objective: We aimed to determine the effects of preoperative evaluation, demographic data including the presence of chronic diseases, surgery indication, obesity frequency, and laboratory data on survival, admission to intensive care unit (ICU), and mortality rate of patients requiring internal examination scheduled for elective, noncardiac surgery. Methods: A total of 1230 patients, for whom an elective, noncardiac surgery was planned between June 1, 2020, and October 1, 2020, in our hospital, were prospectively evaluated and their follow-up assessment was conducted at 6 months. Preoperative American Society of Anesthesiologists scores, demographic information, indication for surgery and surgical method, chronic diseases, height, weight, waist circumference, body mass index (BMI), requirement for postoperative intensive care, and laboratory results were recorded. Results: A total of 1230 patients were included in this study. The mean age was 60.2±12.7 years, and 51.0% (n=624) of the patients were men. Preoperative ASA scores were 16.3% (n=200), 49% (n=603), 32.9% (n=405), and 1.8% (n=22) for ASA-1, ASA-2, ASA-3, and ASA-4, respectively. Patients who would be operated on for malignancy constituted 22.4% (n=276). Ophthalmic surgeries were the most evaluated patient group (n=438) and hypertension (HT), diabetes mellitus (DM), and coronary artery disease (CAD) are the most common diseases. The hospitalization rate in the ICU was 5.7% (n=70) and the mortality rate was 1.5% (n=18). The highest rate of mortality among this group was seen in patients with malignancy diagnosis (18.5%), admission to ICU (10.9%), and BMI value <18.5 kg/m2 and ≥40 kg/m2. Conclusion: The three most common diseases during internal medicine preoperative evaluation were HT, DM, and CAD. Patients with malignancy and very high or very low BMI were found to be significantly related to more requirements for ICU and mortality in the postoperative period. We think that close monitoring of these patient groups in the perioperative and postoperative periods is important for survival. [ABSTRACT FROM AUTHOR]