PMID- 31151461
OWN - NLM
STAT- MEDLINE
DCOM- 20190821
LR  - 20200225
IS  - 1749-8090 (Electronic)
IS  - 1749-8090 (Linking)
VI  - 14
IP  - 1
DP  - 2019 May 31
TI  - A retrospective analysis of 62,571 cases of perioperative adverse events in 
      thoracic surgery at a tertiary care teaching hospital in a developing country.
PG  - 98
LID - 10.1186/s13019-019-0921-z [doi]
LID - 98
AB  - OBJECTIVES: Despite a long history of concerns regarding patient safety during 
      clinical care, some patients undergoing thoracic surgery continue to experience 
      adverse events (AEs). AEs are a major significant source of perioperative 
      morbidity and mortality following thoracic surgery. This study analysed the 
      causes, treatment and prognosis of perioperative AEs to provide a reference for 
      further surgical safety. METHODS: The authors collected a total of 62,571 
      thoracic surgery anaesthesia records via the Anaesthesia Information Management 
      System (AIMS) from 14 August 2006 to 14 August 2017 and obtained 150 cases of 
      perioperative serious AEs from the "adverse events registration" subsystem. The 
      related hospitalization data of the 150 patients were analysed, including 
      anaesthesia, recovery room time, ICU records and follow-up outcomes. The causes 
      of these AEs were classified as follows: events related to the patients' 
      pathogenic conditions(P); surgery-related factors(S); anaesthesia-related 
      factors(A); and interactions between pathogenic, surgical and anaesthesia factors 
      (P&S&A). We then analysed the main clinical manifestations, causes and treatment 
      of these events. RESULTS: The overall rate of perioperative AEs in thoracic 
      surgery (n = 62,571) was 0.2%. Of these, 10.7% were. caused by P and 23.3% by A; 
      neither cause led to patient death. S and P&S&A accounted for 55.3 and 10.7% of 
      AEs, respectively; together, they accounted for 66%. Twelve patients with 
      postoperative AEs caused by S or P&S&A died within 3 days (8% of 150 cases). A 
      total of 33%(50/150) of patients experienced sudden cardiac arrest (SCA) and 
      recovered successfully. Surgical massive haemorrhage (22%, 33/150) was reported 
      as a predominant mortality-related outcome in this group, and 8 of the 12 deaths 
      were caused by massive haemorrhage. CONCLUSIONS: The rate of perioperative AEs 
      after thoracic surgery was 0.2%. AEs must be identified and treated immediately. 
      An important factor in anaesthesia-related events was respiratory management. Two 
      major clinical manifestations of surgery-related events were cardiac arrest and 
      massive haemorrhage. Cardiac arrest was the major factor contributing to AEs, but 
      its adverse consequences could be avoided with timely discovery and proper 
      treatment. Massive haemorrhage is a significant cause of mortality that can be 
      prevented with a surgeon's early diagnosis and appropriate interventions.
FAU - Li, Qiongzhen
AU  - Li Q
AD  - Department of Anesthesiology of Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, 200030, China.
FAU - Zhang, Xiaofeng
AU  - Zhang X
AD  - Department of Anesthesiology of Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, 200030, China.
FAU - Xu, Meiying
AU  - Xu M
AD  - Department of Anesthesiology of Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, 200030, China.
FAU - Wu, Jingxiang
AU  - Wu J
AUID- ORCID: 0000-0003-1471-5640
AD  - Department of Anesthesiology of Shanghai Chest Hospital, Shanghai Jiao Tong 
      University, Shanghai, 200030, China. Wu_jingxiang@shchest.org.
LA  - eng
GR  - 16411967600/the Shanghai Committee of Science and Technology/
GR  - 2014YCDC20500/Major Key projects of Shanghai Chest Hospital Affiliated to 
      Shanghai Jiao Tong University/
GR  - SHDC12014241/Appropriate Technical Subject of Shanghai Municipal Hospital/
PT  - Journal Article
DEP - 20190531
PL  - England
TA  - J Cardiothorac Surg
JT  - Journal of cardiothoracic surgery
JID - 101265113
MH  - Anesthesia/*adverse effects
MH  - Blood Loss, Surgical/mortality
MH  - China/epidemiology
MH  - Developing Countries/*statistics & numerical data
MH  - Heart Arrest/etiology
MH  - Hospitals, Teaching/*statistics & numerical data
MH  - Humans
MH  - Intraoperative Complications/epidemiology/*etiology
MH  - Perioperative Period
MH  - Postoperative Complications/epidemiology/*etiology/therapy
MH  - Prognosis
MH  - Retrospective Studies
MH  - Tertiary Care Centers/statistics & numerical data
MH  - Thoracic Surgical Procedures/*adverse effects
PMC - PMC6544963
OTO - NOTNLM
OT  - Adverse events
OT  - Perioperative
OT  - Thoracic surgery
COIS- The authors declare that they have no competing interest.
EDAT- 2019/06/04 06:00
MHDA- 2019/08/23 06:00
PMCR- 2019/05/31
CRDT- 2019/06/02 06:00
PHST- 2018/04/17 00:00 [received]
PHST- 2019/05/13 00:00 [accepted]
PHST- 2019/06/02 06:00 [entrez]
PHST- 2019/06/04 06:00 [pubmed]
PHST- 2019/08/23 06:00 [medline]
PHST- 2019/05/31 00:00 [pmc-release]
AID - 10.1186/s13019-019-0921-z [pii]
AID - 921 [pii]
AID - 10.1186/s13019-019-0921-z [doi]
PST - epublish
SO  - J Cardiothorac Surg. 2019 May 31;14(1):98. doi: 10.1186/s13019-019-0921-z.