Trend of Critical Anesthetic Complications at a Tertiary Hospital, 2007-2016

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Wanna Angkasuvan


Objectives: To identify trend of critical anesthetic complications at tertiary hospital, compare to that reported by the Royal College of Anesthesiologists of Thailand (RCAT), describe level GHI and direct anesthetic related complications.

Methods: Annual reports (2007 to 2016) of anesthetic department at Hatyai hospital was retrospectively examined. The following data were collected: demographic data of anesthetic practices, top 3 of critical complications, death within 24 hours, cardiac arrest, awareness, difficult intubation and failed intubation yearly.

Results: The 156,725 anesthetic practices were examined. There had been increasing number of elderly patients, patients with ASA II and III, and those undergoing general anesthesia. There were 258 complications which the top 3 events being reintubation, pulmonary edema and cardiac arrest. The degree of severity was mostly as level F which led to prolonged hospital stay (43.9%). The incidents of death within 24 hours were highest in 2008 (31.91:10,000) and lowest in 2015 (11.95:10,000), while death on table and cardiac arrest remained unchanged. Difficult intubation had decreased markedly since 2013. Anesthetic practices undertaken after failed intubation were cancellation of the operations, changing techniques of anesthesia and using surgical airway. For awareness, 19 patients were reported that occurred in female, duringcesarean section and recall during incision or suture.

Conclusions: Trend of death within 24 hours and difficult intubation in anesthetic practices was in line with national trend reported by RCAT. Human factors and latent risk factors might have led to repeating events in 10 years.

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Original articles


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