Perioperative Emergencies: Who, What, When, Where, Why?

Abstract

Throughout the last several decades, the perioperative mortality rate from anesthesia care has declined, shifting focus to perioperative emergencies. Data on these emergencies, often referred to as "Anesthesia STAT" calls (STATs), are lacking at adult hospitals. The goal of this study was to determine the etiology of STATs at a major academic medical center and to determine surgical cases and patient comorbid conditions that increase the risk for STATs. This was a retrospective observational study. This study took place at a large academic medical center. Patients who underwent anesthesia care were included in this study. No interventions were performed during this study. Data collected included the etiologies of STATs, patient demographic information, patient comorbid conditions, and surgeries during which STATs occurred. Between February 1, 2019, and January 31, 2020, 92 STATs occurred during 58,547 anesthetic cases, with an incidence rate of 0.16%. The most common etiology for a STAT was cardiac arrest, followed by respiratory compromise. Surgical services associated with a significant increase of STATs included general, thoracic, oral/maxillofacial, and vascular surgery. Comorbid conditions that significantly increased the risk of STATs included hypertension, coronary artery disease, congestive heart failure, obstructive sleep apnea, diabetes, and chronic kidney disease. Cardiac arrest is the most common etiology of STATs. Specific surgical services and comorbid conditions are associated with an increased risk of STATs.