Pediatric anesthesia adverse events: the Thai Anesthesia Incidents Study (THAI Study) database of 25,098 cases.
BACKGROUND
The Thai Anesthesia Incidents Study (THAI Study) is the first national study of anesthesia outcomes during anesthesia practice in Thailand. The authors extracted data of 25,098 pediatric cases from THAI Study.


OBJECTIVE
To report patient, surgical, and anesthetic profiles in order to determine the incidences of adverse events and their related factors.


METHODS
A multi-centered prospective descriptive study was conducted among 20 hospitals across Thailand over a year from March 1, 2003 to February 28, 2004. Data in children aged 15 years and younger describing practices and adverse events were collected during anesthesia, in the recovery room and 24 hours postoperative period.


RESULTS
Infants (0-1 year) had a significantly higher rate of adverse events compared with adults (4.6% versus 1.2%). Desaturation was the most common adverse event. The adverse events happened mostly during anesthesia (67%). Infants had significantly higher incidences of delayed detection of esophageal intubation, desaturation, reintubation, cardiac arrest, death, and drug error than older children and adults. Incidences of desaturation, reintubation, difficult intubation, coma/convulsion, cardiac arrest, and death were significantly higher in children with ASA physical status 3-5 than those with ASA physical status 1-2.


CONCLUSIONS
Infants are prone to higher adverse events compared with older children and adults. Main adverse events were respiratory-related and they occurred mostly during anesthesia.
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. nuchamd@yahoo.com
Nutchanart
N
Bunchungmongkol
Wanna
W
Somboonviboon
Suwannee
S
Suraseranivongse
Mayuree
M
Vasinanukorn
Waraporn
W
Chau-in
Thanoo
T
Hintong
D000293:Adolescent; D000367:Age Factors; D000777:Anesthetics / Q000009:adverse effects*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D019992:Databases as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D008297:Male; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D012307:Risk Factors; D013785:Thailand
D000777:Anesthetics