Perioperative cardiac arrest in 457,529 anesthetized patients at a single teaching hospital in Korea: a retrospective study
Anesthesia and Pain Medicine 2014³â 9±Ç 2È£ p.144 ~ p.151
ÃÖÀ±Áö(Choi Yoon-Ji) - Inje University College of Medicine Seoul Paik Hospital Department of Anesthesiology and Pain Medicine
ÇѼ±¿í(Han Seon-Uk) - Inje University College of Medicine Seoul Paik Hospital Department of Anesthesiology and Pain Medicine
³ë¿µÁø(Ro Young-Jin) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
¾çÈ«¼®(Yang Hong-Seuk) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
Abstract
Background: This study provides up-to-date survival data on cardiac resuscitation in adult in-patients. The main objectives of the study were to evaluate the incidence, causes, and outcomes of perioperative cardiac arrest. Objective data might encourage more meaningful attitude in anesthesiologists, surgeons, and patients.
Methods: We retrospectively reviewed patients who experienced perioperative cardiac arrest while receiving noncardiac surgery between January 2004 and December 2012. Collected data included patient characteristics, preoperative evaluations, American Society of Anesthesiologists Physical Status (ASA PS) classification, surgical status (e.g., elective or emergency), type of surgery, and outcomes.
Results: We identified 30 cases of perioperative cardiac arrest that occurred in 457,529 anesthetized patients (incidence = 0.66 per 10,000 anesthetized patient; all-cause mortality = 0.21 per 10,000 anesthetic cases). Two-thirds of patients (19 of 30) were emergency cases (21% survival rate; 4 of 19 patients). Most cardiac arrest patients (60%; 18 of 30 patients) were ASA PS IV?V, and only 40% patients were ASA PS I, II and III. Four cases were associated with anesthesia and the patient recovered, and 3 patients recovered after resuscitation. The main causes of cardiac arrest were respiratory- (75%) and medication-related events (25%).
Conclusions: In accordance with anesthetic management guidelines and the development of anesthetic agents, anesthesia-related cardiac arrests decreased in terms of incidence and mortality. However, we recommend that clinicians cautiously keep in mind airway management and the administration of medications, which are important preventative factors.
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Anesthesia, Cardiac arrest, Resuscitation
KMID :
1155520140090020144
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