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Intra-operative cardiac arrests
A A Sanusi1, A Soyannwo, S D Amanor-Boadu
1Department of Anaesthesia University College Hospital, Ibadan, Nigeria.
Insights
Intraoperative cardiac arrests occurred in 55 of 10,000 operations. Emergency surgery and higher American Society of Anesthesiologists (ASA) status were linked to increased risk and poorer prognosis.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Outcomes
Background:
- Intraoperative cardiac arrest poses a significant risk to patient safety during surgery.
- Understanding the incidence and associated factors is crucial for improving patient outcomes in operating suites.
Purpose of the Study:
- To determine the incidence of intraoperative cardiac arrests at University College Hospital (UCH), Ibadan.
- To identify factors associated with intraoperative cardiac arrest.
- To explore factors influencing prognosis following intraoperative cardiac arrest.
Main Methods:
- Retrospective, descriptive, and cross-sectional study design.
- Data collected from theatre records, intensive care records, case notes, and pathology reports.
- Analysis of 6,356 operations performed between January 1994 and December 1998.
Main Results:
- An overall incidence of 55 cardiac arrests per 10,000 operations was observed.
- Emergency operations (68.6%) and higher American Society of Anesthesiologists (ASA) status (III-V: 71.4%) were associated with cardiac arrest.
- Full recovery rates were higher in elective cases (41.7%) compared to emergency cases (17.1%).
Conclusions:
- Emergency surgery and ASA status are significant risk factors for intraoperative cardiac arrest.
- Prognosis appears to be influenced by the nature of the operation (elective vs. emergency) and patient's pre-operative health status.
- Findings highlight the need for vigilant monitoring and risk stratification in surgical patients, particularly those undergoing emergency procedures or with compromised health.
Abstract:
This is a review of patients who had cardiac arrest in the operating suites at the University College Hospital (UCH), Ibadan between January 1994 and December 1998. The main objectives of the study were to evaluate the incidence of intraoperative cardiac arrests, identify associated factors and, in particular, those factors that might be essential for better prognosis. The study was retrospective, descriptive and cross-sectional. The figures were retrieved from the theatre records, the intensive care records, case notes and pathology reports. During the study period, 6,356 operations were performed. There were 35 cardiac arrests giving an incidence of 55 per 10,000 operations. Of the 35 cases, 18(51.4%) were males while 17(48.6%) were females. The age range was 4 months to 84 years (mean 32.5 years) with wide distribution through the decades. Of the twenty-four patients (68.6%) that were done as emergency cases, four patients (17.1%) recovered fully. Of the 11(31.4%) elective cases, 5 (41.7%) made full recovery. Ten patients (28.6%) were ASA I & II, while 25 (71.4%) were graded ASA status III to V. The factors associated with cardiac arrest in this study included emergency operation and the ASA status.