The Thai Anesthesia Incidents (THAI Study) of Anesthetic Risk Factors related to Perioperative Death and Perioperative Cardiovascular Complications in Intracranial Surgery
Phuping Akavipat MD*, Wichai Ittichaikulthol MD**, Lawan Tuchinda MD***, Thepakorn Sothikarnmanee MD****, Sireeluck Klanarong MD*****, Tharnthip Pranootnarabhal MD******
Affiliation : * Department of Anesthesiology, Prasat Neurological Institute, Ministry of Public Health, Bangkok ** Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok *** Department of Anesthesiology, Chulalongkorn University, Bangkok **** Department of Anesthesiology, Khon Kaen University, Khon Kaen ***** Department of Anesthesiology, Buddhachinaraj Hospital, Ministry of Public Health, Phitsanulok ****** Department of Anesthesiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the correlations between anesthetic risk factors and perioperative cardiovascular
complications as well as perioperative death within 72 hours.
Materials and Methods : This case controlled took the data from the Thai Anesthesia Incidents Study (THAI
Study), a prospective multi-centered registry of anesthesia in Thailand. The authors included all the patients
who received intracranial surgery from 20 hospitals throughout Thailand. The present study was divided into
two groups and focused on anesthetic factors that possibly related to perioperative cardiovascular complica-
tions or perioperative death. The statistical analysis were Chi Square test and logistic regression model with
the statistical significance if p-value < 0.05 demonstrated in Odds ratio (OR) and 95% confidence interval.
Results : From the 7,430 patients, there were 63 patients (0.85%) with perioperative cardiovascular compli-
cation. The American Society of Anesthesiologists (ASA) physical status 3-5 (OR 5.77, 95%CI 2.33-14.27) and
the absence of anesthesiologists (OR 2.19, 95%CI 1.06-4.54) had statistical correlation with the cardiovascu-
lar complication. Eighty-four patients (1.13%) who died within 72 hours post operatively were found. The
ASA physical status 3-5 (OR 10.14, 95%CI 3.42-30.02), the emergency circumstance (OR 3.55, 95%CI 1.31-
9.60), and the absence of endtidal carbondioxide monitor (OR 2.27, 95%CI 1.26-4.09) had statistical corre-
lation with the perioperative death.
Conclusion : Predictors of perioperative cardiovascular complications in intracranial surgical patients were
ASA physical status 3-5 and absence of certified board anesthesiologists. Risk factors of perioperative death
were ASA physical status 3-5, emergency condition, and absence or no monitoring of capnometer.
Keywords : Anesthesia, Risk factor, Cardiovascular complication,Perioperative death, Intracranial surgery, Certified board anesthesiologist
