Incidence and Associated Factors of Anesthetic Complications in Pediatric Patients Under General Anesthesia in Samutsakhon Hospital: a Retrospective Cohort Study
Keywords:
anesthetic complications, general anesthesia, incidence, pediatric, risk factorsAbstract
Objective: This study aimed to determine the incidence and associated factors of anesthesia- related complications in pediatric patients undergoing general anesthesia at Samutsakhon Hospital. Materials and methods: This retrospective cohort study was conducted between October 2022 and September 2025, involving 1,804 pediatric patients (aged from birth to 15 yr) who received general anesthesia. Complications were monitored from the induction of anesthesia up to 24 h post-operation. Data were analyzed using descriptive statistics, and independent predictors were identified through multiple logistic regression analysis. Results: The overall incidence of anesthesia-related complications was 18.1%, comprising 578 events. The most frequent complication was delayed recovery (9.8%). Notably, 66.7% of affected patients experienced their first complication during the recovery phase up to 24 h post-operation. Multivariable analysis identified five factors associated with increased odds of complications: ASA physical status ≥ III (aOR 2.22), ENT surgery (aOR 1.64), emergency surgery (aOR 1.61), age > 1-5 yr compared with adolescents (aOR 1.60), and underweight compared with normal weight (aOR 1.39). Conversely, overweight and obesity (aOR 0.53) and a history of upper respiratory infection (aOR 0.58) were associated with lower odds of complications. No anesthesia-related cardiac arrest or mortality occurred. Conclusion: The high incidence reflects the extended monitoring coverage throughout the recovery period, while no life-threatening events were observed. ASA physical status, nutritional status and age can serve as practical tools for preoperative risk stratification, and surveillance should be extended through the first 24 postoperative hours.
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