CLINICAL SPECTRUM OF PREVIOUSLY UNDIAGNOSED COMORBIDITIES IDENTIFIED DURING ROUTINE PRE-ANAESTHETIC ASSESSMENT AND THEIR IMPLICATIONS FOR PERIOPERATIVE RISK STRATIFICATION: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Routine pre-anaesthetic assessment (PAC) is an essential component of
perioperative care that enables the identification of systemic comorbidities, supports preoperative
optimization, and facilitates individualized anaesthetic planning. This study evaluated the
spectrum of previously diagnosed and newly detected comorbidities among adults undergoing
elective surgery.
Objective: To assess the prevalence of known and newly detected systemic comorbidities
identified during routine pre-anaesthetic assessment and their implications for perioperative risk
stratification.
Methods: A prospective observational study was conducted in the Department of Anaesthesiology
at Chettinad Hospital and Research Institute, Kelambakkam. One hundred adults aged 18–60 years
scheduled for elective surgery under general, spinal, or regional anaesthesia were enrolled.
Demographic details, clinical history, physical examination findings, and routine preoperative
investigations were recorded. Patients were evaluated for systemic comorbidities and classified
according to the American Society of Anesthesiologists (ASA) Physical Status Classification.
Results: Among the 100 patients, 65% were females and 35% were males. Most patients were
classified as ASA II (54%), followed by ASA III (25%) and ASA I (21%). Hypertension was the
most common comorbidity (55%), including 44% previously diagnosed and 11% newly detected
cases. Diabetes mellitus was identified in 39% of patients, including 30% known and 9% newly
detected cases. Previously unrecognized systemic comorbidities were detected in 26% of patients.
Conclusion: Routine PAC effectively identified previously undiagnosed systemic comorbidities,
enabling perioperative risk stratification, individualized anaesthetic planning, and timely
preoperative optimization to improve patient safety.
Keywords: Pre-anaesthetic assessment; Comorbidities; Elective surgery; Perioperative risk
stratification; Hypertension; Diabetes mellitus.