Parada cardíaca perioperatória: uma análise evolutiva da incidência de parada cardíaca intraoperatória em centros terciários no Brasil

Vane, Matheus Fachini; Nuzzi, Rafael Ximenes do Prado; Aranha, Gustavo Fabio; Luz, Vinícius Fernando da; Malbouisson, Luíz Marcelo Sá; Gonzalez, Maria Margarita; Auler, José Otávio Costa; Carmona, Maria José Carvalho

doi:10.1016/j.bjan.2016.01.001

Cited by 13 publications

(8 citation statements)

References 21 publications

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“…7 , 18 When compared to European countries, this study’s results show a higher rate of incidence of cardiac arrest, by two to six times. 8 , 12 , 32 – 34 There are dissimilarities in many factors, especially characteristics of the sample and selection of study samples. Some studies have included non-trauma patients in their study samples.…”

Section: Discussionmentioning

confidence: 99%

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Siriphuwanun

Punjasawadwong

Saengyo

2018

RMHP

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PurposeThe aim of this study was to determine the incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery.Patients and methodsThis retrospective cohort study was approved by the medical ethical committee, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Thailand. Data of 19,683 trauma patients who received anesthesia between January 2007 and December 2016, such as patient characteristics, surgery procedures, anesthesia information, anesthetic drugs, and cardiac arrest outcomes, were analyzed. Data of patients receiving local anesthesia by surgeons or monitoring anesthesia care (MAC) and those with much information missing were excluded. Factors associated with perioperative cardiac arrest were identified using univariate analysis and the multiple regression model. A stepwise algorithm was chosen at a P-value of <0.20 which was selected for multivariate analysis. A P-value of <0.05 was concluded as statistically significant.ResultsThe perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were as follows: age >65 years (risk ratio [RR] =1.41, CI =1.02–1.96, P=0.039), American Society of Anesthesiologist (ASA) physical status 3 or higher (ASA physical status 3–4, RR =4.19, CI =2.09–8.38, P<0.001; ASA physical status 5–6, RR =21.58, CI =10.36–44.94, P<0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each P<0.001), cardiopulmonary comorbidities (RR =1.55, CI =1.10–2.17, P=0.012), hemodynamic instability with shock prior to receiving anesthesia (RR =1.60, CI =1.21–2.11, P<0.001), and having a history of alcoholism (RR =5.27, CI =4.09–6.79, P<0.001).ConclusionThe incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with patient’s factors, especially old age and cardiopulmonary comorbidities, a history of drinking alcohol, increased ASA physical status, hemodynamic instability with shock prior to surgery, and sites of surgery such as brain, thorax, abdomen, and the major vascular region. Anesthesiologists and surgeons should be aware of a warning system and a well-equipped track to manage the surgical trauma patients.

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Section: Discussionmentioning

confidence: 99%

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Siriphuwanun

Punjasawadwong

Saengyo

2018

RMHP

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“…Two systematic reviews with a proportion meta-analysis of worldwide studies have shown that the rates of both perioperative and anesthesia-related CA and mortality are much higher in developing countries than in developed countries [ 6 , 7 ]. A review of the studies conducted in Brazil showed that there was a reduction in the rate of perioperative CA during the last 25 years, similar to the global trend [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative and anesthesia-related cardiac arrest and mortality rates in Brazil: A systematic review and proportion meta-analysis

et al. 2020

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Introduction Studies have shown that both perioperative and anesthesia-related cardiac arrest (CA) and mortality rates are much higher in developing countries than in developed countries. This review aimed to compare the rates of perioperative and anesthesia-related CA and mortality during 2 time periods in Brazil. Methods A systematic review with meta-analysis of full-text Brazilian observational studies was conducted by searching the Medline, EMBASE, LILACS and SciELO databases up to January 29, 2020. The primary outcomes were perioperative CA and mortality rates and the secondary outcomes included anesthesia-related CA and mortality events rates up to 48 postoperative hours. Results Eleven studies including 719,273 anesthetic procedures, 962 perioperative CAs, 134 anesthesia-related CAs, 1,239 perioperative deaths and 29 anesthesia-related deaths were included. The event rates were evaluated in 2 time periods: pre-1990 and 1990–2020. Perioperative CA rates (per 10,000 anesthetics) decreased from 39.87 (95% confidence interval [CI]: 34.60–45.50) before 1990 to 17.61 (95% CI: 9.21–28.68) in 1990–2020 (P < 0.0001), while the perioperative mortality rate did not alter (from 19.25 [95% CI: 15.64–23.24] pre-1990 to 25.40 [95% CI: 13.01–41.86] in 1990–2020; P = 0.1984). Simultaneously, the anesthesia-related CA rate decreased from 14.39 (95% CI: 11.29–17.86) to 3.90 (95% CI: 2.93–5.01; P < 0.0001), while there was no significant difference in the anesthesia-related mortality rate (from 1.75 [95% CI: 0.76–3.11] to 0.67 [95% CI: 0.09–1.66; P = 0.5404). Conclusions This review demonstrates an important reduction in the perioperative CA rate over time in Brazil, with a large and consistent decrease in the anesthesia-related CA rate; however, there were no significant differences in perioperative and anesthesia-related mortality rates between the assessed time periods.

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“…In the present study, the incidence rates found for cardiac arrest and death outcomes were much lower than the rates found in the literature. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 There were 407 cases of cardiac arrest in 1,621,241 anesthetic procedures, giving an incidence of 251 cases per 10,000 anesthesias for the two-year period (2014–2015). Although there has been a decrease in the incidence of this outcome over the past 25 years, the incidence of 2.5 for the two-year period is still well below the incidence of 13 cases per 10,000 anesthesias for 2007, as observed in a previous study.…”

Section: Discussionmentioning

confidence: 99%

Adverse events in anesthesiology: analysis based on the Logbook tool used by specializing physicians in Brazil

Pavão

Mattos

Silva

et al. 2019

Brazilian Journal of Anesthesiology (English Edition)

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Parada cardíaca perioperatória: uma análise evolutiva da incidência de parada cardíaca intraoperatória em centros terciários no Brasil

Cited by 13 publications

References 21 publications

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Perioperative and anesthesia-related cardiac arrest and mortality rates in Brazil: A systematic review and proportion meta-analysis

Adverse events in anesthesiology: analysis based on the Logbook tool used by specializing physicians in Brazil

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