A prospective study of anaesthesia related morbidity and mortality - abstract

ABSTRACT

A 2-year (1981-82) prospective study was undertaken to determine the incidence of morbidity and mortality related to anaesthesia at the University Hospital of the West Indies. Data was obtained from all patients subjected to anaesthesia relating to their pre-operative, intra-operative and post-operative (recovery room or ICU) course and, in relevant instances, the convalescent ward. A total of 8,334 anaesthetics were administered and the ages of the patients ranged from 3 days to 96 years (mean 36 years). Three hundred and sixty patients (4.31 per cent) developed a complication as a result of anaesthesia and, of these, 12 patients (0.14 per cent of the total) died. Five patients died following post-operative cardio-respiratory arrest whereas 6 patients died of intra-operative arrhythmia and/or hypotension. One patient, a 1-year old child, died post-operatively of hypoxic brain damage. The incidence of various organ system involvement among non-fatal complications were as follows respiratory (45 percent), cardiovascular (32 percent), musculo-skeletal (3 percent) central nervous (<1 percent). Respiratory complications included laryngospasm and/or bronchospasm (49 percent), post-operative respiratory obstruction (15 percent), post-operative respiratory insufficiency (19 percent), pulmonary oedema following aspiration (4 percent). Fifty-five patients needed post-operative mechanical ventilation in the ICU. Aspiration of stomach contents occurred in 6 instances and 5 of these patients involved anaesthesia for emergency caesarean section. All of these patients improved with supportive therapy (AU)