Perioperative Cardiac Arrest: A 3-Year Prospective Study from a Tertiary Care University Hospital

Abdelkarim Aloweidi; Subhi Alghanem; Isam Bsisu; Omar Ababneh; Mustafa Alrabayah; Khaled Al-Zaben; Ibraheem Qudaisat

doi:10.2147/DHPS.S332162

Perioperative Cardiac Arrest: A 3-Year Prospective Study from a Tertiary Care University Hospital

Drug Healthc Patient Saf. 2022 Jan 10:14:1-8. doi: 10.2147/DHPS.S332162. eCollection 2022.

Authors

Abdelkarim Aloweidi¹, Subhi Alghanem¹, Isam Bsisu¹, Omar Ababneh¹, Mustafa Alrabayah¹, Khaled Al-Zaben¹, Ibraheem Qudaisat¹

Affiliation

¹ Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman, 11942, Jordan.

Abstract

Purpose: Perioperative cardiac arrests (CAs) are a rare but catastrophic perioperative complication. Much about incidence, risk factors, and outcomes of such events are still unknown. This study investigated anesthesia-related CAs at a tertiary teaching hospital.

Methods: CA incidence within 24 hours of anesthesia administration was prospectively identified from May 1, 2016 to April 31, 2019. Each CA was matched by four other cases without CA receiving anesthesia on the same date and under similar operating conditions. The CA cases were reviewed and assigned to one of three groups: anesthesia-related, anesthesia-contributing, and anesthesia not related.

Results: A total of 58,303 patients underwent 73,557 procedures under anesthesia during the study period. In sum, 27 CAs were reported for incidence of 3.7 per 10,000 anesthesia administrations (95% CI 2.3-5.1). Eleven CA were anesthesia-related for incidence of 1.5 per 10,000 anesthesia administrations. Four CA cases were anesthesia-contributing for incidence of 0.5 per 10,000 anesthesia administrations, while 53% of the anesthesia-related and -contributing CAs were due to respiratory problems. American Society of Anesthesiologists (ASA) physical status score, cardiovascular surgery, emergency surgery, and increased duration of surgery were significantly correlated with CA incidents when compared to the control group. ASA physical status score is an independent risk factor of the occurrence of perioperative CA (OR 7.6, 95% CI 2.6-22.4; P<0.001).

Conclusion: Identifying factors associated with increased risk for anesthesia-related CA is of great importance in risk stratification for surgical patients. ASA physical status score was found to be a major factor in predicting perioperative CA, since patients with higher ASA scores had a statistically significant increased risk of CA. Therefore, extra precautions must be taken when dealing with unprepared patients who have uncontrolled medical illnesses, especially those who will be undergoing emergency surgery.

Keywords: anesthesia; cardiac arrests; incidence; surgery.

Grants and funding

This research was funded by the Deanship of Scientific Research, The University of Jordan, Amman, Jordan (572/2016/19).