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Rate of Major Anesthetic-Related Outcomes in the Intraoperative and Immediate Postoperative Period After Cardiac Surgery

Published:December 18, 2015DOI:https://doi.org/10.1053/j.jvca.2015.08.006

      Objectives

      To examine anesthesia-centered outcomes in a large cohort of patients undergoing coronary artery bypass grafting (CABG) or valvular heart surgery.

      Design

      A retrospective study with univariate and multivariate logistic regression to identify independent predictors for mortality.

      Setting

      Diverse setting including university, small, medium, and large community hospitals.

      Participants

      All patients undergoing CABG or valve surgery in the National Anesthesia Clinical Outcomes Registry (NACOR) from the Anesthesia Quality Institute.

      Interventions

      None.

      Measurements and Main Results

      Common anesthesia-centered outcomes including arrhythmia, cardiac arrest, death, hemodynamic instability, hypotension, inadequate pain control, nausea/vomiting, seizure, stroke, reintubation and transfusion were reported. All outcomes, consistent with NACOR data entry, were defined as occurring intraoperatively or during phase I or II recovery in the PACU. Death occurred in 0.15% of CABGs and 0.23% of valve surgeries. Age less than 18, American Society of Anesthesiologists physical status (ASA PS) classification of 5, and mean case duration greater than 6 hours were associated with increased mortality (p<0.05). The presence of a board-certified anesthesiologist was associated with decreased odds for mortality.

      Conclusions

      Death was a rare outcome in this cohort, reflecting the infrequent occurrence of intraoperative or immediate postoperative death. The presence of a board-certified anesthesiologist represented a modifiable risk factor for reducing mortality risk.

      Key Word

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