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Original ArticleOpen Access
The Thai Anesthesia Incident Monitoring Study (Thai AIMS): An Analysis of Perioperative Complication in Geriatric Patients
Tuchinda L 
,
Sukchareon I ,
Kusumaphanyo C ,
Hintong T ,
Suratsunya T ,
Thienthong S
,
Sukchareon I ,
Kusumaphanyo C ,
Hintong T ,
Suratsunya T ,
Thienthong S Background: The present study was a part of the multi-centered study of model of Anesthesia related adverse events in
Thailand by incident report. (The Thai Anesthesia Incident Monitoring Study or Thai AIMS). The objective of the present study
was to identity and analyze anesthesia incident in geriatric patients in order to find out the frequency distribution, clinical
courses, management of incidents and investigation of model appropriate for possible corrective strategies.
Material and Method: This study was a prospective descriptive multicentered study conducted between January 1, 2007 and
June 30, 2007. Incident reports from 51 hospital across Thailand were sent to data management unit on anonymous and
voluntary basis. The authors extracted relevant data from the incident reports on geriatric patients (age 65 or more). The
cases were reviewed by 3 anesthesiologists. Any disagreement was discussed and judged to achieve a consensus. Descriptive
statistics was used.
Results: Among 407 incident reports and 559 incidents, there were more male (52.8%) than female (46.7%) patients with ASA
PS 2,3,4 and 5 = 38.6%, 42.8%, 14.5% and 4.2% respectively. Surgical specialties that posed high risk of incidents were
general, orthopedic, neurological, urologic and otorhiolaryngological surgery. Common places where incidents occurred
were operating room (57.1%), ward (30.9%) and recovery room (12.0%). Common occurred incidents were arrhythmia
needing treatment (30.0%), death within 24 hr. (24.6%), desaturation (21.9%), cardiac arrest (16.2%) and reintubation
(16.0%). The causes of the incidents were mostly attributed from patients underlying diseases and conditions. Most common
outcomes were major physiologic changes with 26.5% fatal outcome at 7 days. The most common contributing factor was
human factor (inappropriate decision and inexperience). Vigilance and having more experience could be the minimizing
factors.
Conclusion: Incidents in geriatric patients were similar to all age group patients with a higher incidents in death within 24
hr. The outcome were more serious resulting in 26.5% fatal outcome at 7 days. Quality assurance activity, clinical practice
guidelines and improved supervision were suggested corrective strategies.
Keywords: Anesthesia, Adverse events, Multicentered study, Complication, Geriatric
Thailand by incident report. (The Thai Anesthesia Incident Monitoring Study or Thai AIMS). The objective of the present study
was to identity and analyze anesthesia incident in geriatric patients in order to find out the frequency distribution, clinical
courses, management of incidents and investigation of model appropriate for possible corrective strategies.
Material and Method: This study was a prospective descriptive multicentered study conducted between January 1, 2007 and
June 30, 2007. Incident reports from 51 hospital across Thailand were sent to data management unit on anonymous and
voluntary basis. The authors extracted relevant data from the incident reports on geriatric patients (age 65 or more). The
cases were reviewed by 3 anesthesiologists. Any disagreement was discussed and judged to achieve a consensus. Descriptive
statistics was used.
Results: Among 407 incident reports and 559 incidents, there were more male (52.8%) than female (46.7%) patients with ASA
PS 2,3,4 and 5 = 38.6%, 42.8%, 14.5% and 4.2% respectively. Surgical specialties that posed high risk of incidents were
general, orthopedic, neurological, urologic and otorhiolaryngological surgery. Common places where incidents occurred
were operating room (57.1%), ward (30.9%) and recovery room (12.0%). Common occurred incidents were arrhythmia
needing treatment (30.0%), death within 24 hr. (24.6%), desaturation (21.9%), cardiac arrest (16.2%) and reintubation
(16.0%). The causes of the incidents were mostly attributed from patients underlying diseases and conditions. Most common
outcomes were major physiologic changes with 26.5% fatal outcome at 7 days. The most common contributing factor was
human factor (inappropriate decision and inexperience). Vigilance and having more experience could be the minimizing
factors.
Conclusion: Incidents in geriatric patients were similar to all age group patients with a higher incidents in death within 24
hr. The outcome were more serious resulting in 26.5% fatal outcome at 7 days. Quality assurance activity, clinical practice
guidelines and improved supervision were suggested corrective strategies.
Keywords: Anesthesia, Adverse events, Multicentered study, Complication, Geriatric
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