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Multi-centered study of anesthesia related adverse events in Thailand: The Thai anesthesia incident study (TAIS)

สมรัตน์ จารุลักษณานันท์; Somrat Charulaksananan; ยอดยิ่ง ปัญจสวัสดิ์วงศ์; สุวรรณี สุรเศรณีวงศ์;
Date: 2547
Abstract
Objectives: To develop and institute a methodology for the study of anesthesia related adverse outcome in 20 hospitals in Thailand: 7 university hospitals, 5 tertiary hospitals, 4 general hospitals and 4 district hospitals.Methods: The Thai Anesthesia Incident Study (TAIS) was prospectively conducted by collecting data of all consecutive anesthetics in preplanned structured data entry form (form 1). The database including patients demographics, anesthetic, surgical factors and anesthesia related adverse anesthetic records and hospital charts and interview attending anesthesia personnel. Data were collected and entered by double entry technique and analysis of outcomes determined for preoperative intraoperative and 24 hours postoperative periods.Results: The 86265 patients were take care by anesthesia personnel. The mean (S.D.)age, weight and height of the patients were 38.5 (21.4) years, 53.2 (18.4) kg. And 146.6 (38.5) cm. In this study 87.5 % of patients were classified as ASA physical status 1 or 2 and 31.2 % were in emergency setting. The six most common choices of anesthesia were general anesthesia (61%), spinal anesthesia (23.3%), total intravenous anesthesia (5.5%), monitor anesthesia care (3.4%), brachial plexus block (2.9%) and epidural anesthesia (1.2%) respectively etc. There were 53 cases (0.1%) of cardiac arrest and 17 cases (0.02%) death within 24 hours due to all etiologies. The common respiratory adverse events were desaturation 123 cases (0.1%), difficult intubation 83 cases (0.1%), reintubation 26 cases (0.03%) and esophageal intubation 19 cases (0.02%). Other important adverse events were coma/CVA/convulsion 9 cases, myocardial ischemia or infarction 8 cases, anaphylactoid or anaphylaxis 9 cases. The systemic events were 10 cases of drug error, 18 cases of equipment malfunction or failure, 5 cases of anesthesia personnel hazard, 6 cases of unplanned hospital admission and 27 cases of unplanned ICU admission.Conclusion: This was first large anesthesia epidemiological data which can be implied to anesthesia practice in Thailand. The rates of cardiac arrest and death within 24 hours due to allKey words: anesthesia, complication, adverse events. Cardiac arrest, death
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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