PRE-OPERATIVE STATUS OF SERUM SODIUM, POTASSIUM, BLOOD UREA NITROGEN AND CREATININE IN HYPERTENSIVE PATIENTS SCHEDULED FOR ELECTIVE NON-CARDIAC SURGERY
DOI:
https://doi.org/10.70520/kjms.v19i1.844Keywords:
surgical outcomes, serum sodium, potassium, BUN, creatinineAbstract
Objective:
- To assess frequency of abnormal values of pre-operative serum sodium, potassium, BUN and creatinine
- Their association with surgical delay, consult generated and additional cost in hypertensive patients planned for elective non-cardiac surgery.
Methods: This cross-sectional study was performed in Agha Khan university hospital, Karachi Pakistan, from 18.11.2020 to 18.07.2021. Patients 19 and above, ASA class I-III who were diagnosed to have hypertension at least 6 months and longer and undergoing elective non-cardiac surgery were included in the study. Patients with the following were excluded: acute or chronic kidney disease, having electrolyte imbalance secondary to endocrine disorders and those having poor cardiac reserve {ejection fraction of less than 40 percent or having regional wall motion abnormalities}. A total of 177 patients who met the inclusion and exclusion criteria were enrolled. Details of all study participants who visited the pre-operative anesthesia clinic and diagnosed to have hypertension were retrieved at the end of the day by checking their pre-operative forms for demographic data, past medical and drug history, laboratory workup and surgical outcomes.
Results: 177 patients undergoing elective non-cardiac surgery were assessed. Mean age of participants was 58.73 years (SD 11.23). Most patients were ASA class II (70.6%). Most frequent pre-operative laboratory abnormality was BUN (13.6%) followed by potassium (10.7%), then sodium (5.6%) and lastly creatinine (2.3%). 89.8% patients proceeded to surgery without delay and 4% had delays but due to reasons apart from preoperative abnormalities. Only 1.1% patients faced postponement due to preoperative abnormalities.
Conclusion: The study revealed significant abnormalities in laboratory values only some of which led to surgical delay and generated additional consultation.
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