Major incidents and complications in otherwise healthy patients undergoing elective procedures: results based on 1.37 million anaesthetic procedures
Schiff, Jan-Henrik, Welker, A., Fohr, B., Henn-Beilharz, A., Bothner, U., Van Aken, H., Schleppers, A., Baldering, H.J., and Heinrichs, W. (2014) Major incidents and complications in otherwise healthy patients undergoing elective procedures: results based on 1.37 million anaesthetic procedures. British Journal of Anaesthesia, 113 (1). pp. 109-121.
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Abstract
Background: Improved anaesthesia safety has made severe anaesthesia-related incidents, complications, and deaths rare events, but concern about morbidity and mortality in anaesthesia continues. This study examines possible severe adverse outcomes or death recorded in a large national surveillance system based on a core data set (CDS).
Methods: Cases from 1999 to 2010 were filtered from the CDS database. Cases were defined as elective patients classified as ASA physical status grades I and II (without relevant risk factors) resulting in death or serious complication. Four experts reviewed the cases to determine anaesthetic involvement.
Results: Of 1 374 678 otherwise healthy, ASA I and II patients in the CDS database, 36 met the study inclusion criteria resulting in a death or serious complication rate of 26.2 per million [95% confidence interval (CI), 19.4–34.6] procedures, and for those with possible direct anaesthetic involvement, 7.3 per million cases (95% CI, 3.9–12.3).
Conclusions: This is the first study assessing severe incidents and complications from a national outcome-tracking database. Annual identification and review of cases, perhaps with standardized database queries in the respective departments, might provide more detailed information about the cascades that lead to unfortunate outcomes.
| Item ID: | 38769 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1471-6771 |
| Keywords: | complications, computerized anaesthesia, medical records systems, mortality, outcome assessment |
| Date Deposited: | 14 May 2015 04:17 |
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