Background Cardiovascular complications following non-cardiac procedures remain a significant contributor to perioperative morbidity and mortality. Preoperative testing, especially before low-risk interventions such as upper gastrointestinal endoscopy and colonoscopy, is often overutilised. This study aimed to assess the frequency of cardiovascular assessments prior to endoscopic procedures and evaluate their influence on patient management and clinical outcomes in a hospitalized setting.
Methods This retrospective cohort study evaluated hospitalized patients undergoing upper gastrointestinal endoscopy or colonoscopy at Shariati Hospital. Data on demographics, medical history, and clinical outcomes were extracted from electronic and paper records. Statistical analyses were conducted using SPSS, with significance defined as p < 0.05.
Results A total of 270 patients were included, of whom 184 (68.1%) were male, with a mean age of 56.7±17.9 SD years. Cardiovascular consultations were performed in 158 patients (58.5%), and 101 patients (37.4%) underwent echocardiography. The mean hospital length of stay was significantly longer for patients receiving cardiology consultation (7.2 ± 6.0 days) compared to those who did not (5.1 ± 3.5 days, p < 0.01). The incidence of hospital-acquired pneumonia was significantly higher among consulted patients (5.1% vs. 0.0%, p = 0.02), as was the rate of overall nosocomial infections (13.9% vs. 3.6%, p < 0.01). Cardiovascular medications were initiated in 31 (19.6%) of consulted patients. There was no significant difference in the rate of major adverse cardiovascular events (MACE) between groups (p=0.57). MACE occurred in 2 (1.8%) of patients who did not undergo cardiology consultation compared to 1 (0.6%) in consulted patients.
Conclusion Pre-endoscopic cardiac evaluations appear to significantly influence procedural planning, pharmacologic management, and length of stay. While leading to greater resource utilization (prolonged hospital stay and increased infection rates), these evaluations provided no measurable clinical benefit in reducing major adverse cardiovascular events. These findings underscore the need for judicious risk assessment and strict adherence to guidelines for low-risk endoscopic procedures.
