Document Detail


Predictors of survival following cardiac arrest in patients undergoing noncardiac surgery: a study of 518,294 patients at a tertiary referral center.
MedLine Citation:
PMID:  12883397     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The authors determined the incidence of cardiac arrest and predictors of survival following perioperative cardiac arrest in a large population of patients at a tertiary referral center. METHODS: Medical records of patients who experienced cardiac arrest in the perioperative period surrounding noncardiac surgery between January 1, 1990, and December 31, 2000, were reviewed. Logistic regression identified characteristics associated with immediate (>or= 1 h) and hospital survival, with P <or= 0.01 considered statistically significant. RESULTS: Cardiac arrest occurred in 223 of 518,294 anesthetics (4.3 per 10,000) during the study period. Frequency of arrest for patients receiving general anesthesia decreased over time (7.8 per 10,000 during 1990-1992; 3.2 per 10,000 during 1998-2000). The frequency of arrest during regional anesthesia (1.5 per 10,000) and monitored anesthesia care (0.7 per 10,000) remained consistent. Immediate survival after arrest was 46.6%, and hospital survival was 34.5%. Twenty-four patients (0.5 per 10,000) had cardiac arrest related primarily to anesthesia. From multivariate analysis, patients who experienced arrest due to bleeding were less likely to survive hospitalization (P = 0.001). Survival was also lower for patients who experienced arrest during nonstandard working hours (P = 0.006) and for patients who had protracted hypotension before arrest (P < 0.001). CONCLUSIONS: The overall frequency of arrest for patients receiving anesthesia decreased during the study period. Most arrests were not due to anesthesia-related causes, and most patients experiencing anesthesia-related arrest survived to hospital discharge. Although many factors determining survival may not be amenable to modification, the fact that arrests during nonregular working hours had worse outcomes may indicate that the availability of human resources influences survival.
Authors:
Juraj Sprung; Mary E Warner; Michael G Contreras; Darrell R Schroeder; Christopher M Beighley; Gregory A Wilson; David O Warner
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  99     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-28     Completed Date:  2003-08-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-69     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Division of Biostatistics, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Anesthesia / mortality
Anesthesia Recovery Period
Cardiopulmonary Resuscitation
Cardiovascular Diseases / complications
Child
Child, Preschool
Databases, Factual
Female
Heart Arrest / etiology,  mortality*
Humans
Infant
Intraoperative Complications / mortality*
Male
Middle Aged
Postoperative Period
Predictive Value of Tests
Recovery Room
Risk Assessment
Risk Factors
Sex Factors
Survival Analysis
Comments/Corrections
Comment In:
Anesthesiology. 2003 Aug;99(2):248-50   [PMID:  12883394 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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