Abstract

BackgroundThe present survey evaluated the incidence of perioperative cardiac arrests in a Chinese tertiary general teaching hospital over ten years.MethodsThe incidence of cardiac arrest that occurred within 24 h of anaesthesia administration was retrospectively identified in the Third Affiliated Hospital of Sun Yat-Sen University between August 2007 and October 2017. Overall, 152,513 anaesthetics were included in the study period. Data collected included patient characteristics, American Society of Anaesthesiologists (ASA) physical status score, surgical specialty and anaesthesia technique. Cardiac arrests were assigned to one of three groups: “anaesthesia-related”, “anaesthesia-contributing” or “anaesthesia-unrelated”.ResultsIn total, 104 cardiac arrests (6.8:10,000) and 34 deaths (2.2:10,000) were obtained. Among them, eleven cardiac arrests events were anaesthesia-related, resulting in an incidence of 0.7 per 10,000 anaesthetics. Sixteen cardiac arrests events were found to be anaesthesia-contributing, resulting in an incidence of 1.0 per 10,000 anaesthetics. Cardiovascular adverse events were the major events that contributed to anaesthesia-related cardiac arrest. Differences were found between events related and unrelated to anaesthesia with regard to ASA physical status and anaesthesia technique (P < 0.05).ConclusionsAnaesthesia-related cardiac arrest occurred in 11 of 104 cardiac arrests within 24 h of anaesthesia administration. Most cardiac arrests related to anaesthesia were due to cardiovascular events, including arrhythmia and hypotension after intravenous narcotic, as well as haemorrhage. ASA physical status of at least 3 and subarachnoid block appeared to be relevant risk factors for anaesthesia-related cardiac arrest.

Highlights

  • The present survey evaluated the incidence of perioperative cardiac arrests in a Chinese tertiary general teaching hospital over ten years

  • Most cardiac arrests related to anaesthesia were due to cardiovascular events, including arrhythmia and hypotension after intravenous narcotic, as well as haemorrhage

  • More than 10% of major surgical procedures worldwide are performed in China [1], there is limited information available on the incidence of anaesthesia-related cardiac arrest and risk factors for perioperative cardiac arrest in Chinese tertiary hospitals

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Summary

Introduction

The present survey evaluated the incidence of perioperative cardiac arrests in a Chinese tertiary general teaching hospital over ten years. An overall perioperative cardiac arrest rate of 7.19/10,000 anaesthetics was reported worldwide from the 1990s to the 2000s [2]. More than 10% of major surgical procedures worldwide are performed in China [1], there is limited information available on the incidence of anaesthesia-related cardiac arrest and risk factors for perioperative cardiac arrest in Chinese tertiary hospitals. Most Chinese publications regarding anaesthesia-related cardiac arrest are published in Chinese journals that are not indexed by the global databases. A multicentre prospective survey, including 106,569 patients from eleven Chinese teaching hospitals, found the incidence of cardiac arrest for patients undergoing regional anaesthesia to be 0.09/10,000 [9]. Studies on perioperative cardiac arrest for large unselected patient populations are still lacking. As the incidence of cardiac attest within the 24 h perioperative period is an important component of the anaesthesia quality control index system published by the National Health and Family Planning Commission of the People’s Republic

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