Publication: Perioperative and Anesthetic Adverse events in Thailand (PAAd Thai) incident reporting study: Anesthetic profiles and outcomes
Issued Date
2017-02-01
Resource Type
ISSN
1875855X
19057415
19057415
Other identifier(s)
2-s2.0-85016048154
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Mahidol University
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SCOPUS
Bibliographic Citation
Asian Biomedicine. Vol.11, No.1 (2017), 21-32
Suggested Citation
Somrat Charuluxananan, Wimonrat Sriraj, Yodying Punjasawadwong, Siriporn Pitimana-Aree, Varinee Lekprasert, Thewarug Werawatganon, Wirat Wasinwong, Prapa Ratanachai, Dujduen Sriramatr, Sunida Atichat, Wanna Angkasuvan, Chuthamat Somchat, Duangporn Tanutanud, Thidarat Ariyanuchitkul, Jaroonpong Choorat, Krairerk Sintavanuruk, Jeratkana Janngam Perioperative and Anesthetic Adverse events in Thailand (PAAd Thai) incident reporting study: Anesthetic profiles and outcomes. Asian Biomedicine. Vol.11, No.1 (2017), 21-32. doi:10.5372/1905-7415.1101.535 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/41990
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Title
Perioperative and Anesthetic Adverse events in Thailand (PAAd Thai) incident reporting study: Anesthetic profiles and outcomes
Author(s)
Somrat Charuluxananan
Wimonrat Sriraj
Yodying Punjasawadwong
Siriporn Pitimana-Aree
Varinee Lekprasert
Thewarug Werawatganon
Wirat Wasinwong
Prapa Ratanachai
Dujduen Sriramatr
Sunida Atichat
Wanna Angkasuvan
Chuthamat Somchat
Duangporn Tanutanud
Thidarat Ariyanuchitkul
Jaroonpong Choorat
Krairerk Sintavanuruk
Jeratkana Janngam
Wimonrat Sriraj
Yodying Punjasawadwong
Siriporn Pitimana-Aree
Varinee Lekprasert
Thewarug Werawatganon
Wirat Wasinwong
Prapa Ratanachai
Dujduen Sriramatr
Sunida Atichat
Wanna Angkasuvan
Chuthamat Somchat
Duangporn Tanutanud
Thidarat Ariyanuchitkul
Jaroonpong Choorat
Krairerk Sintavanuruk
Jeratkana Janngam
Other Contributor(s)
Chulalongkorn University
Khon Kaen University
Chiang Mai University
Mahidol University
Prince of Songkla University
Hatyai Hospital
Srinakharinwirot University
Chonburi Regional Hospital
Lamphun Hospital
Lampang Hospital
Maharaj Nakhon Ratchasima Hospital
Sunpasitthiprasong Hospital
Charoen Krung Pracharak Hospital
Bangkok Metropolitan Administration
Khon Kaen University
Chiang Mai University
Mahidol University
Prince of Songkla University
Hatyai Hospital
Srinakharinwirot University
Chonburi Regional Hospital
Lamphun Hospital
Lampang Hospital
Maharaj Nakhon Ratchasima Hospital
Sunpasitthiprasong Hospital
Charoen Krung Pracharak Hospital
Bangkok Metropolitan Administration
Abstract
Background: The Royal College of Anesthesiologists of Thailand initiated registry and reporting of anesthesia service incidents and outcomes in 2005. Objectives: The Perianesthetic Anesthetic Adverse Events in Thailand (PAAd Thai) study aimed to investigate patient, surgical, and anesthetic profiles, and suggest strategies for prevention of adverse events. Methods: A prospective descriptive study was conducted in 22 hospitals across Thailand. Each hospital was invited to report, on an anonymous basis, any perianesthetic adverse incident during 12 months (between January 1 and December 31, 2015). A standardized incident report form was completed to determine the type of incident, and where, when, how, and why it occurred using closed and open-ended questionnaires. Data regarding main anesthetic techniques were also reported monthly. Descriptive statistics were used. Results: For 333,219 cases, 2,206 incident reports with 3,028 critical incidents were reported. The incidents commonly occurred in male patients (52.0%), aged ≤10 y (13.0%) and ≥70 y (18.2%). The incidence of adverse events included cardiac arrest within 24 h (15.5:10,000), death (13.0:10,000), reintubation (11.1:10,000), esophageal intubation (8.5:10,000), difficult intubation (8.0:10,000), and malignant hyperthermia (1:200,000). General, cardiothoracic, neurological, and otorhinolaryngological surgical specialties posed a high risk of incidents. Operating and recovery rooms were common locations for incidents. Conclusion: In the past decade, there were dramatic reductions of perioperative cardiac arrests and difficult intubations. Common factors related to critical incidents were inexperience, emergency, inadequate preanesthetic evaluation, inappropriate decisions, lack of vigilance, and inexperienced assistants. Suggested corrective strategies are compliance with guidelines, additional training, and improvement of supervision and quality assurance.