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

AIM: 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). PATIENTS AND 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). CONCLUSION: Intercurrent medical disease was commonly found in patients above 60years and is a predictor of both intraoperative and postoperative adverse events.