[Retrospective study of anesthetic deaths in the first 24 hours: review of 82,641 anesthesias.].
OBJECTIVE
Since the first reported anesthetic death, many attempts have been made to study the incidence of risk factors, complications and mortality associated to anesthesia and surgery. The estimated perioperative mortality risk varies from 0.05 to 10 cases per 10,000 anesthesias. This study aimed at reporting the incidence of anesthetic-surgical death in the first 24 hours, at our hospital.


METHODS
Charts had been reviewed from 82,641 surgeries performed in 1998 and 1999. Deaths were analyzed according to Edwards classification, and by age, gender, physical status, (ASA), type of surgery and anesthesia.


RESULTS
Cause of the deaths according to Edwards classification has shown that 91.04% were class V, 3.77% class VI, 2.13% class VII, 2.84% class IV and 0.23% were class I. Age above 65 years accounted for 1.48% of deaths; adults incidence was 0.48%; the incidence in children aged 1 to 12 years was 0.11%; in children aged 31 days to 1 year it was 1.29% and in neonates up to 30 days of life the incidence was 2.88%. Death ratio as compared to total deaths was 59.2% in adults, 30.2% in patients above 65 years of age, 2.8% at the age 1 to 12, 4% in patients with 31 days of life to 1 year and 3.8% in newborn babies. Males represented 66.3% of deaths and females 33.7%. The distribution by ASA physical status was: ASA I - 11.1%, ASA II - 5.2%, ASA III - 30.9%, ASA IV - 34.4% and ASA V - 18.4%. Emergency surgeries accounted for 67.2% of deaths and elective surgeries for 32.8%. General incidence of the deaths was 0.51% being the highest in cardiac (1.88%) and vascular (1.87%) surgeries.


CONCLUSIONS
Anesthetic-surgical deaths in the years 1998 and 1999 were considered inevitable according to Edwards classification. The highest incidence of deaths was in neonates. Most deaths occurred in males, ASA III or above patients, and emergency vascular or cardiac surgeries.
Chan
Raquel Pei Chen
RP
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, USP.
Auler Junior
José Otávio Costa
JO