Complications Associated with Anaesthesia???A Prospective Survey in France

Abstract

A prospective survey of complications associated with anaesthesia was carried out in France from 1978 to 1982 in a representative sample of 198,103 anaesthetics performed in 460public and private institutions chosen at random in the country as a whole. There were 268 major complications associated with anaesthesia occurring during or within 24 hours of anaesthesia (one per 739 anaesthetics), among which 67 were followed by death within 24 hours and 16 by coma persistent after the 24th hour. The incidence of death and coma was one per 2387 anaesthetics. The incidence of death and coma totally attributable to anaesthesia was one per 7924 anaesthetics. Fifty-eight per cent of complications occurred during anaesthesia while 42 per cent were observed during the recovery period. Mortality was lower following complications during anaesthesia than for those during the recovery period. Half of the deaths and cases of coma totally attributable to anaesthesia were due to postanaesthetie respiratory depression. The rate of complications appeared to be dependent upon several risk factors: the patient' s age, the number of assoclated diseases, the pre-operative status, whether the operation was an emergency and the duration of procedure.

Early postoperative emergencies requiring an intensive care team interventionThe role of ASA physical status and after‐hours surgery

“…The majority of early postoperative emergencies occurred within the first 24 h of surgery and outside normal working hours on the wards. In a previous study [21], 75% of major postanaesthetic complications occurred within the first 5 h; this was probably related to the fact that there were no recovery unit or high-dependency facilities at the time of this survey. Although the introduction of a high-dependency unit has been shown to reduce the number of cardiac arrests and mortality in hospitals [22], there is currently no accurate model using pre-operative risk factors, intra-operative anaesthetic technique and postoperative management for predicting the need for intensive care [23].…”

“…These risk factors of major postoperative morbidity and mortality have been documented in the literature. The independent risk factors of severe complications, death or coma within 24 h of anaesthesia include patient's age, number of associated diseases, pre-operative status, emergency surgery and the duration of procedure [21]. While the ASA physical status was not originally intended to be used as an estimate of 'operative risk' [24], it is a predictor of postoperative outcome [25].…”

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

“…[1][2][3][4] Certain factors have been linked to the severity of patient outcomes, including the volume, nature, and acidity of the aspirate. [5][6][7][8] The preoperative assessment of the risk of pulmonary aspiration relies essentially on the patient's history, and the clinical management typically adheres to fasting recommendations of current guidelines.…”

Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study

“…A large prospective survey conducted by anesthesiologists from France demonstrated that the rate of complications related to anesthesia increased approximately ten times in patients aged 80 years compared to those aged 30 years [14]. On the other hand, Greenberg et al [15] and Mohr [16] reported that age was less of a factor in surgical risk than physiologic status.…”