Perioperative mortality and morbidity for the year 2000 in 532 Japanese Society of Anesthesiologists certified training hospitals: with a special reference to surgical sites--report of the Japan Society of Anesthesiologists Committee on Operating Roo

摘要

Perioperative mortality and morbidity in Japan for the year 2000 were analyzed with special reference to operative regions. The total number of analyzed cases was 903,086. The percentages for each operative region were as follows, CRANIOTOMY 4.5%, THORACOTOMY 3.5%, HEART and GREAT-VESSELS 3.7%, THORACOTOMY with LAPAROTOMY 0.7%, LAPAROTOMY 30.4%, CESARIAN SECTION 3.3%, HEAD-NECK-ENT 14.7%, CHEST-ABDOMEN-PERINEUM 14.0%, SUPINE 3.6%, EXTREMITY including PERIPHERAL-VESSEL 17.2%, OTHERS 4.4%. The incidence of serious events, including cardiac arrest and severe hypotension and hypoxemia developing to cardiac arrest, was 26.74 per 10,000 anesthetics in all operative regions. The events were observed more frequently in HEART and GREAT-VESSELS 170.39, THORACOTOMY with LAPAROTOMY 85.84 and THORACOTOMY 63.63, and less frequently in CHEST-ABDOMEN-PERINEUM 10.49, CESARIAN SECTION 10.95 and EXTREMITY including PERIPHERAL-VESSEL 13.42. Regarding the prognosis of events, the cases with no sequelae were 63.4% in all operative regions. While there were fewer cases with no sequelae in CRANIOTOMY 49.0%, THORACOTOMY with LAPAROTOMY 43.4% and HEART and GREAT-VESSELS 44.4%, there were more cases in HEAD-NECK-ENT 86.9% and CHEST-ABDOMEN-PERINEUM 89.5%. The incidence of serious events totally attributable to anesthetic management was 5.24 per 10,000 anesthetics in all operative regions. The events were observed more frequently in THORACOTOMY 12.91 and SPINE 8.02, and less frequently in LAPAROTOMY except CESARIAN SECTION 4.11 and EXTREMITY including PERIPHERAL-VESSEL 4.65. The main cause of events in THORACOTOMY was inadequate airway management and in SPINE was inadequate airway management and the overdose or miss selection for drugs. Regarding the prognosis of events totally attributable to anesthetic management, the cases with no sequelae were 91.8% in all operative regions. There were fewer cases with no sequelae in HEART and GREAT-VESSELS 82.6%. The incidence of serious events totally attributable to anesthetic management wasone fifth of all serious events in all operative regions. While the total deaths from 903,086 cases, including deaths in the operating room or within 7 postoperative days, were 641 cases (7.10 per 10,000 cases), the deaths totally attributable to anesthesia were 9 cases (0.10 per 10,000 cases).