Critical incidents during anesthesia: prospective audit

Area of Science:

• Anesthesiology
• Patient Safety
• Critical Incident Analysis

Background:

• Critical incident reporting and analysis are essential for patient safety in anesthesiology.
• Understanding the frequency, causes, and outcomes of critical incidents is crucial.

Purpose of the Study:

• To determine the frequency and characteristics of critical incidents during anesthesia.
• To identify the main causes, contributing factors, and influence on patient outcomes.
• To assess the prevalence of incident reporting and analysis.

Main Methods:

• A multicenter prospective audit was conducted across 13 hospitals in Ukraine from January 1 to December 1, 2021.
• Anesthesiologists voluntarily reported critical incidents using a Google form.
• The study was approved by the Bogomolets National Medical University ethics committee.

Main Results:

• The incidence of critical incidents was 9.35 per 1000 anesthetic procedures, with respiratory and cardiovascular events being most common.
• Factors increasing risk included elective surgery, older age, and higher ASA status; regional anesthesia reduced risk.
• Incidents often occurred during induction or maintenance, with insufficient preoperative assessment and patient-specific features being key causes. Preventable incidents were common, with significant consequences including prolonged hospital stay, ICU transfer, and mortality.
• Most incidents were reported via paper forms, with electronic reporting being less common.

Conclusions:

• Critical incidents in anesthesia are frequent and can have severe consequences.
• Reporting and analysis are crucial for improving patient safety.
• Developing web-based reporting systems is recommended for local and national levels.