An Observational Study on Prevalence and Perioperative Impact of Arterial Hypertension and Diabetes Mellitus among Adult Surgical Patients

Abstract

Background: Arterial hypertension and diabetes mellitus is very common co-morbidities among surgical patients and can affect the perioperative management. Health care team even goes ahead with preoperative screening for undetected diabetes many a times. However, how much these diseases affects perioperative anaesthetic management is rarely evaluated. Aim: To assess the prevalence of new, controlled and uncontrolled hypertension, diabetes mellitus and their perioperative impact among adult surgical patients. Methods: With approval, this prospective observational study was conducted in a tertiary care teaching hospital of an island of India during December 2016 to May 2017. Total 958 adults of both sexes, planned for elective non-cardiac surgery were included. Arterial hypertension (AHTN) and Diabetes Mellitus (DM) was defined as per JNC-7 and ADA definition. The prevalence of new, controlled, uncontrolled AHTN and DM and their perioperative anaesthetic were assessed. INSTAT software was used for statistical analysis and p < 0.05 was considered as significant. Results: Total 941 patients {438 (46.55%) male} with mean standard deviation age and weight of 46.26 15.86 year and 59.19 12.02 kilogram were included for analysis. The median ASA physical status and NICE surgical invasiveness grade were 2 for both. The prevalence of AHTN, DM and both were 20.72%, 13.71% and 6.695% respectively; not statistically different among male and female. 64.1% hypertensive and 48.06% diabetic patients had BP > 140/90 mmHg and blood sugar >180 mg% respectively. 20.51% hypertensive and 22.48% diabetic needed change in perioperative management leading to delay in surgery and extra hospital visits and stay. Conclusion: The prevalence of AHTN and DM is high among adults and increases significantly with age. Both gender is affected equally. Uncontrolled AHTN and DM are very high and are alarming to initiate measures to tackle these important non-communicable diseases.