Complications associated with anaesthesiaa — prospective survey in France

Tiret, Laurence; Desmonts, J. M.; Hatton, F; Vourc'h, G

doi:10.1007/bf03010747

Cited by 423 publications

(44 citation statements)

References 14 publications

(1 reference statement)

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“…This is similar to other published studies in perioperative cardiac arrest and mortality [45]- [47]. The higher incidence among males [20] [46] [47] can be explained by the predisposition of men to trauma, violence, and vascular disease compared to women.…”

Section: Cardiovascular Arrest In Operating Theatresupporting

confidence: 90%

Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

Zeng¹,

Ng²,

Thong³

2016

IJCM

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Introduction: Critical incident monitoring is important in quality improvement as it identifies potential risks to patients by analyzing adverse events or near-misses. Methods: This study analyses the reported incidents in a tertiary hospital over a 4-year period. Results: A total of 441 incidents were reported out of 98,502 anesthetics performed during the study period. Of these incidents, 67 resulted in no harm caused, 116 with unanticipated ICU admissions and 20 mortalities. The odds of having a critical incident increased with ASA status: from an odds ratio of 2.08 (95% CI: 1.58 to 2.74) for ASA 2 patients compared to ASA1, to OR of 13.70 (5.91 to 31.74) in ASA 5 compared to ASA 1. Critical incidents also have higher odds occurring out of hours (OR 1.7 (1.45 to 2.23) compared to daytime hours (08:00-17:00). They occurred most commonly in maintenance phase (142, 32.7%), followed by induction (120, 27.6%). The most common types of incidents include airway and respiratory (110, 24.9%) followed by drug related incidents (67, 15.2%). Human error was attributed as a significant contributing factor in 276 incidents (61.5%) followed by patient factors in 112 incidents (25.4%). Mitigating factors such as vigilance by staff involved were significant in 136 incidents (30.3%). Conclusion: Higher ASA status appears to be the most important factor associated with actual or potential patient harm in our study. Also significant, was time of incident, with incidents more likely out of hours. Critical incident reporting is a valuable part of quality assurance. We should continue to invest in incident reporting, incident analysis and improvement plans.

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Section: Cardiovascular Arrest In Operating Theatresupporting

confidence: 90%

Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

Zeng¹,

Ng²,

Thong³

2016

IJCM

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“…The previous studies reported that the incidence of difficult intubation was 1.3-13% which was depending to the criteria employed for its definition. [1234202122] The incidence of DVL was 6.9% in our study and it was comparable with the some previous studies. [202122] The difference in incidence of DVL can be due to various factors such as different anthropometric features that exists among populations, unavailability of uniform grading in description of laryngeal views, application of cricoids pressure, position of head, the degree of muscle relaxation and the type or size of laryngoscope blade.…”

Section: Discussionsupporting

confidence: 91%

“…About 75-50% of cardiac arrests during general anesthesia are because of difficult intubation that causes inadequate oxygenation and/or ventilation, which about 55-93% of them cause death or brain death. [12345] Difficult laryngoscopy (characterized by poor glottic visualization) is equal to difficult intubation in the most patients. The reported data for difficult intubation varies from 1.5-13% in the patients who are undergoing surgery.…”

Section: Introductionmentioning

confidence: 99%

Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD

2014

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Background:Preoperative using of anatomical landmarks detects potentially difficult laryngoscopies. The main object of the present study was to evaluate the predictive power of Extended Mallampati Score (EMS) in comparison with modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT) in isolation and combination.Materials and Methods:Four hundred seventy sixadult patients who candidate for elective surgery under general anesthesia requiring endotracheal intubation were included in this study and evaluated based of all four factors before surgery. This study was randomized prospective double - blind. After that, laryngoscopy was performed by an anesthesiologist who didn’t involve in preoperative airway assessment and graded based on Cormack and Lehane's classification. We calculated sensitivity, specificity, and area under receiver-operating characteristic (ROC) (AUC) for each score.Results:The AUCof the ROC was significantly more for the ULBT (AUC = 0.820, P = 0.049) and RHTMD score (AUC = 0.845, P = 0.033) than the EMS (AUC = 0.703). This variable was significantly higher for the EMS compared with MMT (0.703 vs. 0.569, P = 0.046 respectively). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score (P = 0.685). The optimalcut-off point for the RHTMD for predicting difficult laryngoscopy was 29.3.Conclusion:EMS predicted difficult laryngoscopy better than MMT while both ULBT and RHTMD had more power than EMS and MMT in this regard. ULBT and RHTMD had similar predictive value for prediction of difficult laryngoscopy in general population.

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“…As the number of comorbidities increases, so does the rate of perioperative complications. Tiret et al [30 ]showed that the number of cases of illness was strongly correlated with the rate of perioperative complications. This effect was more pronounced in the elderly patients.…”

Section: Discussionmentioning

confidence: 99%

A Simple Novel Model to Predict Hospital Mortality, Surgical Site Infection, and Pneumonia in Elderly Patients Undergoing Operation

Huang¹,

Hu²,

Fan³

et al. 2010

Dig Surg

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Background/Aims: Predicting models of operative morbidity and mortality in the geriatric population are important in the prevention of adverse surgical outcomes. Methods: A retrospective review of medical records was performed for patients over 80 years of age who underwent gastrointestinal surgery from 1998 to 2008. Results: 215 patients were identified with a mean age of 83.7 years. Overall morbidity and mortality rates were 48.8 and 14.4%, respectively. Multivariate logistic regression analysis revealed that serum albumin levels [odds ratio (OR) = 0.367, p = 0.0267], postoperative pneumonia (OR = 3.471, p = 0.0101), hollow organ perforation or anastomosis combined with leakage (OR = 7.600, p = 0.0126), and preoperative systemic inflammatory response syndrome (OR = 3.186, p = 0.0323) were significant predictors of hospital mortality. Moreover, albumin (OR = 0.270, p = 0.0002) and physical disability (OR = 3.802, p = 0.0009) were significant predictors of postoperative pneumonia, and albumin (OR = 0.491, p = 0.0212) and enterotomy (OR = 3.335, p = 0.0208) were significant predictors of surgical site infections. Conclusion: This study provides novel predicting models to identify the elderly surgical patients at high risk, who should receive more intensive preventive and perioperative care.

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Complications associated with anaesthesiaa — prospective survey in France

Cited by 423 publications

References 14 publications

Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD

A Simple Novel Model to Predict Hospital Mortality, Surgical Site Infection, and Pneumonia in Elderly Patients Undergoing Operation

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