Universität zu Köln

Hohn, Andreas, Machatschek, Jan-Nicolas, Franklin, Jeremy ORCID: 0000-0003-1536-0925 and Padosch, Stephan A. (2018). Incidence and risk factors of anaesthesia-related perioperative cardiac arrest: A 6-year observational study from a tertiary care university hospital. Eur. J. Anaesth., 35 (4). S. 266 - 273. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1365-2346

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Abstract

BACKGROUNDIn recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce.OBJECTIVESTo determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest.DESIGNRetrospective cohort study.SETTINGDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany.INTERVENTIONSPerioperative critical incident reports between 2007 and 2012 were screened, and reports on cardiac arrest within 24h postoperatively were identified. Cardiac arrests were classified as anaesthesia-related', anaesthesia-contributory' or anaesthesia-unrelated' by two reviewers independently. Univariate and multi-variate logistic regression analysis was used to identify risk factors associated with perioperative cardiac arrest.RESULTSAnalysis of 318 critical incidents from 169500 anaesthetics revealed 99 perioperative cardiac arrests. This is an overall incidence of perioperative cardiac arrest of 5.8/10000 anaesthetics [95% confidence interval (CI), 4.7 to 7.0]. The rate of anaesthesia-related cardiac arrest was 0.7/10000 (95% CI, 0.3 to 1.1), and the rate of anaesthesia-contributory cardiac arrest was 1.7/10000 (95% CI, 1.1 to 2.3). Most cardiac arrests related to anaesthesia were due to respiratory events. From the multi-variate analysis, American Society of Anesthesiologists physical status grade at least 3 [P=0.007, odds ratio (OR) 2.59 (95% CI, 1.29 to 5.19)], emergency surgery [P<0.001, OR 4.00 (95% CI, 2.15 to 7.54)] and pre-existing cardiomyopathy [P<0.001, OR 17.48 (95% CI, 6.18 to 51.51)] emerged as predictors of cardiac arrest.CONCLUSIONThese first available European data on perioperative cardiac arrest from a large unselected cohort indicate that the overall perioperative incidence of cardiac arrest at our institution was slightly lower than published in the literature, whereas rates of anaesthesia-related and anaesthesia-contributory cardiac arrest were comparable. Most cardiac arrests related to anaesthesia were due to respiratory events. American Society of Anesthesiologists physical status grade at least 3, emergency surgery and pre-existing cardiomyopathy appear to be relevant risk factors for cardiac arrest.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hohn, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Machatschek, Jan-Nicolas UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED orcid.org/0000-0003-1536-0925 UNSPECIFIED Padosch, Stephan A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-189891
DOI:	10.1097/EJA.0000000000000685
Journal or Publication Title:	Eur. J. Anaesth.
Volume:	35
Number:	4
Page Range:	S. 266 - 273
Date:	2018
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1365-2346
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PEDIATRIC ANESTHESIA; MORTALITY; COMPLICATIONS; FRANCE; EUROPE; DEATH Multiple languages Anesthesiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18989