Intraoperative and Anesthesia-Related Cardiac Arrest and Its Mortality in Older Patients: A 15-Year Survey in a Tertiary Teaching Hospital
MetadataShow full item record
Background: Little information is known about factors that influence perioperative and anesthesia-related cardiac arrest (CA) in older patients. This study evaluated the incidence, causes and outcome of intraoperative and anesthesia-related CA in older patients in a Brazilian teaching hospital between 1996 and 2010.Methods: During the study, older patients received 18,367 anesthetics. Data collected included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA) physical status, anesthesia type, medical specialty team and outcome. All CAs were categorized by cause into one of four groups: patient's disease/condition-related, surgery-related, totally anesthesia-related or partially anesthesia-related.Results: All intraoperative CAs and deaths rates are shown per 10,000 anesthetics. There were 100 CAs (54.44; 95% confidence intervals [CI]: 44.68-64.20) and 68 deaths (37.02; 95% CI: 27.56-46.48). The majority of CAs were patient's disease-/condition-related (43.5; 95% CI: 13.44-73.68). There were six anesthesia-related CAs (3.26; 95% CI: 0.65-5.87) -1 totally and 5 partially anesthesia-related, and three deaths, all partially anesthesia-related (1.63; 95% CI: 0.0-3.47). ASA I-II physical status patients presented no anesthesia-related CA. Anesthesia-related CA, absent in the last five years of the study, was due to medication-/airway-related causes. ASA physical status was the most important predictor of CA (odds ratio: 14.52; 95% CI: 4.48-47.08; P<0.001) followed by emergency surgery (odds ratio: 8.07; 95% CI: 5.14-12.68; P<0.001).Conclusions: The study identified high incidence of intraoperative CAs with high mortality in older patients. The large majority of CAs were caused by factors not anesthesia-related. Anesthesia-related CA and mortality rates were 3.26 and 1.63 per 10,000 anesthetics, with no anesthesia-related CA in the last five years of the study. Major predictors of intraoperative CAs were poorer ASA physical status and emergency surgery. All anesthesia-related CAs were medication-related or airway-related, which is important for prevention strategies.
How to cite this document
Showing items related by title, author, creator and subject.
Pinho, Sheila Zambello de ; Oliveira, José Brás Barreto de ; Gazola, Rodrigo José Cristiano ; Mazotti, Adriano César ; Molero, Camila Schimite ; Mendes, Carolina Borghi ; Mello, Denise Fernandes de ; Marques, Emilia de Mendonça Rosa ; Talamoni, Jandira Liria Biscalquini ; Silva, José Humberto Dias da et al. (Coleção PROGRAD (UNESP), 2011) [Livro]
Pinho, Sheila Zambello de ; Oliveira, José Brás Barreto de ; Pontes, Sueli Rodrigues ; Almeida, Djanira Soares de Oliveira e ; Godoy, Kathya Maria Ayres de ; Rosa, Claudia de Souza ; Nunes, Julianus Araújo ; Salvador, Sérgio Azevedo ; David, Célia Maria ; Vilche Peña, Angel Fidel et al. (Coleção PROGRAD (UNESP), 2011) [Livro]
Pinho, Sheila Zambello de ; Spazziani, Maria de Lourdes ; Mendonça, Sueli Guadelupe de Lima ; Rubo, Elisabete Aparecida Andrello ; Villarreal, Dalva Maria de Oliveira ; Duarte, Camila ; Okamoto, Mary Yoko ; Souza, Thais R. ; Garms, Gilza Maria Zauhy ; Marin, Fátima Aparecida Dias Gomes et al. (Coleção PROGRAD (UNESP), 2012) [Livro]