The outcome of anaesthesia related cardiac arrest in a Sub-Saharan tertiary hospital

Abstract

BackgroundAnaesthesia related cardiac arrest is undesirable, and different attempts have been made to reduce the mortality associated with it through continuous specialist training, and provision of state of art equipment, combined with rigorous research.Patients and methodsWe determined the outcome of all cardiac arrests that occurred within 24 h of a surgical procedure and anaesthesia from January 2013 to May 2014.ResultsThere were nine anaesthesia related cardiac arrest in 4229 cases, (incidence of 21.28 per 10,000), with a mortality of 7/4229; (16.55 per 10,000). There were 60 perioperative cardiac arrests (incidence of 141.88 per 10,000), with a mortality of 55/4229 (130.05 per 10,000). There was return of spontaneous circulation in 34 (56.67%) cases, among them only 7 (20.59%) survived to hospital discharge. The independent determinant of perioperative mortality was the duration of cardiac arrest ⩾ 5 min (RR 10.50, 95% CI 2.721–40.519, p < 0.001), cardiac arrest in the absence of a witness (RR 9.56, 95% CI 2.486–36.752, p < 0.001), nonstandard time of cardiac arrest (RR 3.2, 95% CI 1.792–5.714, p < 0.001), ASA physical status ⩾ III (RR 2.017, 95% CI 1.190–3.417, p = 0.017), and emergency surger (RR 2.17, 95% CI 1.151–4.049, p = 0.011).ConclusionAnaesthesia related cardiac arrest and mortality were linked to cardiovascular depression from halothane overdose in our institution. The burden can be reduced by improving on establishing standard monitoring in the perioperative period, and a team approach to patients care.