title: The Thai Anesthesia Incidents Study (THAI Study) of perioperative death: analysis of risk factors.
abstract: BACKGROUND
  National statistical data of mortality and morbidity related to anesthesia have not been reported. The need to comprehensively examine the cause of death as well as other adverse events prompted the first national study in Thailand.
  
  
  METHODS
  In the Thai Anesthesia Incidents Study (THAI Study), a prospectively defined cohort of patients who underwent anesthesia from February 1, 2003 to January 31, 2004 (n=163,403) was studied. All consecutive patients who died intraoperatively or within the period of 24 hr after anesthesia were classified to determine a relationship with anesthesia by 3 independent reviewers. These data were further analysed to identify contributing factors.
  
  
  RESULTS
  The incidence of 24-hr perioperative death, anesthesia directly related and anesthesia partially related death per 10,000 anesthetics was 28.2 (95% CI 25.7-30.8), 1.7 (95% CI 1.1-2.3) and 4.0 (95% CI 3.1-5.0) respectively. Of 462 deaths, 28 cases (6.5%), 66 cases (14.3%), 61 cases (3.3%), 399 cases (86.7%) and 104 cases (22.6%) were anesthesia directly related, anesthesia partially related, surgical related, patient disease related and system or management related to perioperative death. The common main causes of death were exangination (42.4%), traumatic brain injury (14.3%), sepsis (13.6%), heart failure (5.0%) and hypoxia (5.0%).
  
  
  CONCLUSIONS
  This study shows incidence of 24-hr perioperative death of 1:354 which is comparable with other studies. Quality assurance activity, prevention of human failure and equipment failure, system improvement of perioperative care, availability of recovery room, intensive care unit, efficient blood bank and adequate number of MD. anesthesiologists are suggestive corrective strategies.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. somratcu@hotmail.com
authors.forename: Somrat
authors.initials: S
authors.lastname: Charuluxananan
authors.forename: Thitima
authors.initials: T
authors.lastname: Chinachoti
authors.forename: Aksorn
authors.initials: A
authors.lastname: Pulnitiporn
authors.forename: Sireeluck
authors.initials: S
authors.lastname: Klanarong
authors.forename: Oraluxna
authors.initials: O
authors.lastname: Rodanant
authors.forename: Surasak
authors.initials: S
authors.lastname: Tanudsintum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013785:Thailand