Perioperative cardiac arrest at Siriraj Hospital between 1999-2001

Abstract

Cardiac arrest during the perioperative period is a good indicator of the quality of anesthetic management. The incidence of perioperative cardiac arrest in Siriraj Hospital hasn't been reported before. Our objectives were to determine the incidence of perioperative anesthesia-related cardiac arrest and the results of cardiopulmonary resuscitation in these cases in order to find out how to improve our anesthetic care. This prospective study was undertaken between 1999-2001 by sending a questionnaire to those witnessing a cardiac arrest. The incidence of perioperative cardiac arrest was 8.2 : 10,000 instances of anesthesia with a mortality of 5.6 : 10,000 within 48 hours of the arrest. The incidence of perioperative cardiac arrest that was related to anesthesia was 0.7 : 10,000 instances of anesthesia and the anesthesia related mortality was 0.19 : 10,000 within 48 hours of arrest. Failed cardiopulmonary resuscitation occurred in of occasions 41.7 per cent. There was no difference between intraoperative and postoperative cardiopulmonary resuscitation. Twenty-one per cent of patients experiencing a cardiac arrest were discharged from hospital. Seventy-three per cent of events occurred in patients with an ASA rating 3-5 and most often the cause of arrest was massive or uncontrolled bleeding. In those patients with an ASA rating 1-2 there were no outstanding cause of arrest.