Preoperative Echocardiographic Assessment in Elective Surgery Patients: A Cross-Sectional Study From Duhok, Iraqi Kurdistan

Abstract

Background and aim Echocardiography plays a pivotal role in the preoperative risk assessment of patients undergoing various surgical procedures. Therefore, we conducted this study to detect various cardiac abnormalities through a preoperative echocardiographic study for cases undergoing elective surgeries in Duhok, Iraqi Kurdistan. Methods This cross-sectional study assessed echocardiographic findings in preoperative patients at Azadi Teaching Hospital, Duhok, Kurdistan Region of Iraq, from 2023 to 2024. The study encompasses 468 adult patients. We gathered clinicodemographic characteristics, indications of referral to a preoperative echo study, and the echocardiographic findings, particularly regional wall motion abnormalities, valvular heart diseases, and heart failure (systolic or diastolic/left ventricular hypertrophy). Results In a cohort of 468 patients, 205 (43.80%) were aged 35-54 years, and 269 (57.48%) were female. Most patients (366; 78.21%) resided in Duhok. Nearly only half of the cases 219 (46.79%) had clear preoperative echostudy indications. A total of 289 (61.74%) had no remarkable echocardiographic findings. Diastolic heart failure was most prevalent at 65 (13.89%). Older cases had more prevalent echo findings in terms of valve dysfunctions and heart failure. Notable associations were found between echocardiographic abnormalities and surgical types, particularly higher regional wall motion abnormalities in genito-urinary system operations (4; 8.16%) and valvular heart disease in orthopedic surgeries (13; 15.85%). Conclusions Echocardiographic abnormalities were remarkably observed in patients aged 65 and older. Many cases had no clear indications for preoperative echo study and hence unremarkable echo findings. More scrutiny is indicated during referral, and focusing on older adults’ preoperative cardiac screening is recommended.