Anaesthesia-related Complications:A Report of 55 679 Anaesthesias over a 3-years Period fromthe Hradec Kralove University Hospital in 1999–2001

Overview

Introduction:
Several surveys have evaluated the incidence of anaesthesia-related complications and deaths, however thestatistical data regarding anaesthesia mortality and morbidity fromthe Czech Republic have not been reported yet. The aimof the study was to report and analyze anaesthesia-related complications over a 3 years period from a university hospital.Setting: Dept. of Anesthesiology and Intensive Care.Material and Methods: A retrospective analysis of prospectively collected data during the period between 1999 and 2001was conducted. The number of anaesthesia cases, ASA status, deaths during anaesthesia and within 24 hours, selectedcomplications (aspiration, prolonged recovery, unintentional dural puncture, anaphylactic reaction, dental injury) and socalled major and fatal complications were recorded. The major and fatal complications had to be recorded within 24 hoursof the event into the special protocol comprising all details regarding the event (demographic data, an ASA status, a typeof a complication, a system related to a complication, sequels of a complication, relationship to anaesthesia, qualificationof an anaesthesiologist). Anaesthesia-related mortality was defined as any death during anaesthesia or during a hospitalstay with even possible relationship to anaesthesia. The incidence of the event is expressed as a rate per 10 000 or inpercentage.Results: There were totally 55 679 anaesthesia cases during the observed period. The incidence of all deaths duringanaesthesia and within 24 hours was ~ 8:10 000, resp. ~ 5:10 000, however the majority of deaths were related tonon-anaesthesia causes. The incidence of selected complications: aspiration (~ 2:10 000), prolonged recovery (~ 2:10 000),dural puncture (1.1%),anaphylactic reaction ~ 5:10 000,dental injury ~ 4:10 000. Major and fatal complicationswere recordedin 123 cases, 3 of them after the review process were considered as a minor and not analyzed. Severe life-threateningcomplications during anaesthesia occurred in 48%, deaths during anaesthesia occurred in 29%. The relationship to anaesthesia was found in 44 cases (37%), possible relationship in 19 cases (16%) and no relationship in 57 cases (47%) ofall major and fatal complications. Anaesthesia-related mortality was ~ 0.71:10 000.Conclusion: The overall incidence of anaesthesia-related complications did not differ from similar studies. Major and fatalcomplications occurred in 120 cases (0.21% of all anaesthesias), of those total or possible relationship to anaesthesia wasfound in 63 cases (53%). Anaesthesia-related mortality was ~ 0.71:10 000, which is comparable to other developed countries.

Key words:
anaesthesia – complications – morbidity – mortality