%0 Journal Article %J Anesthesiology %D 2002 %T Anesthetic-related cardiac arrest and its mortality: a report covering 72,959 anesthetics over 10 years from a US teaching hospital %A Newland,M. C. %A Ellis,S. J. %A Lydiatt,C. A. %A Peters,K. R. %A Tinker,J. H. %A Romberger,D. J. %A Ullrich,F. A. %A Anderson,J. R. %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Anesthetics / *adverse effects %K Child %K Child, Preschool %K Female %K Heart Arrest / *chemically induced / mortality %K Hospitals, Teaching %K Humans %K Infant %K Logistic Models %K Male %K Middle Aged %X BACKGROUND: A prospective and retrospective case analysis study of all perioperative cardiac arrests occurring during a 10-yr period from 1989 to 1999 was done to determine the incidence, cause, and outcome of cardiac arrests attributable to anesthesia. METHODS: One hundred forty-four cases of cardiac arrest within 24 h of surgery were identified over a 10-yr period from an anesthesia database of 72,959 anesthetics. Case abstracts were reviewed by a Study Commission composed of external and internal members in order to judge which cardiac arrests were anesthesia-attributable and which were anesthesia-contributory. The rates of anesthesia-attributable and anesthesia-contributory cardiac arrest were estimated. RESULTS: Fifteen cardiac arrests out of a total number of 144 were judged to be related to anesthesia. Five cardiac arrests were anesthesia-attributable, resulting in an anesthesia-attributable cardiac arrest rate of 0.69 per 10,000 anesthetics (95% confidence interval, 0.085-1.29). Ten cardiac arrests were found to be anesthesia-contributory, resulting in an anesthesia-contributory rate of 1.37 per 10,000 anesthetics (95% confidence interval, 0.52-2.22). Causes of the cardiac arrests included medication-related events (40%), complications associated with central venous access (20%), problems in airway management (20%), unknown or possible vagal reaction in (13%), and one perioperative myocardial infarction. The risk of death related to anesthesia-attributable perioperative cardiac arrest was 0.55 per 10,000 anesthetics (95% confidence interval, 0.011-1.09). CONCLUSIONS: Most perioperative cardiac arrests were related to medication administration, airway management, and technical problems of central venous access. Improvements focused on these three areas may result in better outcomes. %B Anesthesiology %7 37457 %V 97 %P 108 - 15 %8 Jul %G eng %N 1 %9 Research Support, Non-U.S. Gov't %M 12131111