Perioperative myocardial ischemia/infarction: study of incidents from Thai Anesthesia Incidence Study (THAI Study) of 163,403 cases.
OBJECTIVE
To analyze incidence, risk factors, clinical course, outcomes of PMI. Degree of anesthesia related to PMI, management, precipitating factors and corrective strategies.


METHODS
PMI cases were extracted from the Thai Anesthesia Incidents Study (THAI Study) database conducted between February 1, 2003 and January 31, 2004, and analyzed using descriptive statistics.


RESULTS
Forty-five cases were recorded as PMI (Suspected myocardial ischemia/infarction) from 20 hospital study centers. The incidence was 2.7:10,000 of all anesthetic services (163,403 cases). PMI occurred more frequently in male, underlying disease of hypertension, diabetes mellitus, ischemic heart disease, ASA class >2, under general anesthesia and during operation. EKG change and hypotension were primary clinical symptoms. PMI caused high mortality (5 cases), high morbidity (6 cases of brain death), high medical cost and change of management plan.


CONCLUSIONS
PMI was strongly impact to both anesthetic and surgical outcomes. Improve quality of anesthetic care for patient at risk and surgical risk reflected the whole anesthetic quality of care.
Rodanant
Oraluxna
O
Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. oraluxanar@hotmail.com
Chinachoti
Thitima
T
Veerawatakanon
Thewarug
T
Charoenkul
Rasanee
R
Somboonviboon
Wanna
W
Kojittavanit
Neerada
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013785:Thailand