Incidência de parada cardíaca e mortalidade em pacientes geriátricos durante a anestesia em hospital universitário de atendimento terciário no período de 15 anos
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Data
2013-02-07
Autores
Nunes, Juscimar Carneiro [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Existem poucas informações a respeito dos fatores que influenciam a incidência de paradas cardíacas e óbitos perioperatórios em pacientes geriátricos. Este estudo avaliou a incidência, as causas e os desfechos de paradas cardíacas no intraoperatório em pacientes geriátricos em hospital universitário de atendimento terciário no período de janeiro de 1996 a dezembro de 2010. A incidência de parada cardíaca nas salas de operação e de recuperação pós-anestésica foi identificada prospectivamente a partir de um banco de dados. Foram realizadas 18.367 anestesias em pacientes geriátricos durante o período do estudo. Foram coletados os dados demográficos dos pacientes, local de ocorrência, classificação do estado físico segundo a American Society of Anesthesiologists (ASA), tipo de atendimento, procedimento anestésico, clínica cirúrgica, fatores desencadeantes e desfechos. Todas as paradas cardíacas e óbitos foram agrupados segundo o fator desencadeante: totalmente relacionada à condição/doença do paciente, totalmente relacionada à cirurgia, totalmente relacionada à anestesia e parcialmente relacionada à anestesia. Ocorreram 100 paradas cardíacas (54,44:10.000) e 68 óbitos (37,02:10.000). A incidência de parada cardíaca foi maior em pacientes com estado físico ASA III ou pior (p=0,02), em cirurgias de emergência (p=0,03) e nas anestesias gerais (p=0,04). O principal fator desencadeante de parada cardíaca e óbito intraoperatório foi a condição/doença do paciente (p=0,03). Ocorreram seis paradas cardíacas relacionadas à anestesia, uma como fator principal e, em cinco, a anestesia foi fator contributivo. Houve três óbitos parcialmente relacionados à anestesia. As principais causas de parada cardíaca relacionadas à anestesia foram decorrentes de problemas no manuseio de vias aéreas e de fármacos administrados. Ocorreram 54,44 paradas cardíacas e 37,02 óbitos por...
Little information is known factors that influence intraoperative cardiac arrest and death in elderly patients. This study evaluated the incidence, causes and outcome of intraoperative cardiac arrest in elderly patients in a Brazilian teaching hospital between 1996 and 2010. The incidence of cardiac arrest in the operating room and Post-anesthesia Care Unit was prospectively identified from an anesthesia database. There were 18,367 anesthetics to elderly patients during the study period. Data collected included patient demographics, surgical procedures, American Society of Anesthesiologists (ASA) physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All cardiac arrests were categorized by cause of cardiac arrest and death into one of four groups: disease-/condition-related, surgery-related, totally anesthesia-related and partially anesthesia-related. There were 100 cardiac arrests (54.44:10,000 anesthetics) and 68 deaths (37.02:10,000 anesthetics). Major incidence of cardiac arrest occurred in patients with ASA physical status of III or poorer (P=0.02) in emergency surgery (P=0.03) and under general anesthesia (P=0.04). The majority of the intraoperative cardiac arrests and deaths were patient disease-/condition-related (P=0.03). There were six anesthesia-related cardiac arrests- one totally and five partially anesthesia-related, and three deaths partially anesthesia-related. The main causes of anesthesia-related cardiac arrest were medication-/airway-related. There were 54.44 cardiac arrests and 37.02 deaths per 10,000 anesthetics in elderly people. The incidence of anesthesia-related cardiac arrest and deaths were 3.26 and 1.63 per 10,000 anesthetics, respectively. Cardiac arrest incidence were higher in patients with severe underlying disease and in emergency surgery. All anesthesia-related cardiac arrests were medication-related or airway-related
Little information is known factors that influence intraoperative cardiac arrest and death in elderly patients. This study evaluated the incidence, causes and outcome of intraoperative cardiac arrest in elderly patients in a Brazilian teaching hospital between 1996 and 2010. The incidence of cardiac arrest in the operating room and Post-anesthesia Care Unit was prospectively identified from an anesthesia database. There were 18,367 anesthetics to elderly patients during the study period. Data collected included patient demographics, surgical procedures, American Society of Anesthesiologists (ASA) physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All cardiac arrests were categorized by cause of cardiac arrest and death into one of four groups: disease-/condition-related, surgery-related, totally anesthesia-related and partially anesthesia-related. There were 100 cardiac arrests (54.44:10,000 anesthetics) and 68 deaths (37.02:10,000 anesthetics). Major incidence of cardiac arrest occurred in patients with ASA physical status of III or poorer (P=0.02) in emergency surgery (P=0.03) and under general anesthesia (P=0.04). The majority of the intraoperative cardiac arrests and deaths were patient disease-/condition-related (P=0.03). There were six anesthesia-related cardiac arrests- one totally and five partially anesthesia-related, and three deaths partially anesthesia-related. The main causes of anesthesia-related cardiac arrest were medication-/airway-related. There were 54.44 cardiac arrests and 37.02 deaths per 10,000 anesthetics in elderly people. The incidence of anesthesia-related cardiac arrest and deaths were 3.26 and 1.63 per 10,000 anesthetics, respectively. Cardiac arrest incidence were higher in patients with severe underlying disease and in emergency surgery. All anesthesia-related cardiac arrests were medication-related or airway-related
Descrição
Palavras-chave
Mortalidade, Hospitais universitarios, Anestesia geriátrica, Parada cardiaca, Idosos - Mortalidade, Geriatric anesthesia
Como citar
NUNES, Juscimar Carneiro. Incidência de parada cardíaca e mortalidade em pacientes geriátricos durante a anestesia em hospital universitário de atendimento terciário no período de 15 anos. 2013. 56 f. Tese (doutorado) - Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2013.