The Thai anesthesia incidents (THAI study) of anesthetic risk factors related to perioperative death and perioperative cardiovascular complications in intracranial surgery

Abstract

Objective: To evaluate the correlations between anesthetic risk factors and perioperative cardiovascular complications as well as perioperative death within 72 hours. Material and Method: This case controlled took the data from the Thai Anesthesia Incidents Study (THAI Study), a prospective multi-centered registry of anesthesia in Thailand. The authors included all the patients who received intracranial surgery from 20 hospitals throughout Thailand. The present study was divided into two groups and focused on anesthetic factors that possibly related to perioperative cardiovascular complications or perioperative death. The statistical analysis were Chi Square test and logistic regression model with the statistical significance if p-value < 0.05 demonstrated in Odds ratio (OR) and 95% confidence interval. Results: From the 7,430 patients, there were 63 patients (0.85%) with perioperative cardiovascular complication. The American Society of Anesthesiologists (ASA) physical status 3-5 (OR 5.77, 95%CI 2.33-14.27) and the absence of anesthesiologists (OR 2.19, 95%CI 1.06-4.54) had statistical correlation with the cardiovascular complication. Eighty-four patients (1.13%) who died within 72 hours post operatively were found. The ASA physical status 3-5 (OR 10.14, 95%CI 3.42-30.02), the emergency circumstance (OR 3.55, 95%CI 1.31-9.60), and the absence of endtidal carbondioxide monitor (OR 2.27, 95%CI 1.26-4.09) had statistical correlation with the perioperative death. Conclusion: Predictors of perioperative cardiovascular complications in intracranial surgical patients were ASA physical status 3-5 and absence of certified board anesthesiologists. Risk factors of perioperative death were ASA physical status 3-5, emergency condition, and absence or no monitoring of capnometer.