Intraoperative reported adverse events in children.
BACKGROUND
Significant intraprocedural adverse events (AE) are reported in children who receive anesthesia for procedures outside the Operating Rooms (NORA). No study, so far, has characterized AE in children who receive anesthesia in the operating rooms (ORA) and NORA when anesthesia care is provided by the same team in a consistent manner.


OBJECTIVE
We used the same patient-specific Quality Assurance questionnaires (QAs), to elucidate incidences of intraoperative reported AE for children receiving anesthesia in NORA and ORA locations. Through multivariate logistic regression analysis, we assessed the association between patient's AE risk and procedure's location while adjusting for American Society of Anesthesiologists (ASA) status, age, and unscheduled nature of the procedure.


METHODS
After Institutional Review Board approval, we used returned QAs of patients under 21 years, who received anesthesia from our pediatric anesthesia faculty from May 1 2006 through September 30, 2007. We analyzed QA data on: service location, unscheduled/scheduled procedure, age, ASA status, presence, and type of AE. We excluded QAs with incomplete information on date, location, age, and ASA status.


RESULTS
We included 8707 cases, with 3.5% incidence of reported AE. We had 1898 NORA and 6808 ORA cases with AE incidence of 2.5% and 3.7%, respectively. Multivariate regression analysis revealed that patients with higher ASA status or younger age had higher incidence of reported AE, irrespective of location or unscheduled nature of the procedure. The most common AE type, for both sites, was respiratory related (1.9%).


CONCLUSIONS
Pediatric reported AE incidence was comparable for NORA and ORA locations. Younger age or higher ASA status are associated with increased risk of AE.
Kakavouli
Athina
A
Department of Anesthesiology, Columbia University, New York, NY 10032, USA.
Li
Guohua
G
Carson
Margaret P
MP
Sobol
Julia
J
Lin
Christine
C
Ohkawa
Susumu
S
Huang
Lin
L
Galiza
Carolyn
C
Wood
Alastair
A
Sun
Lena S
LS
D000293:Adolescent; D000768:Anesthesia, General / Q000009:adverse effects* / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D009873:Operating Rooms; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult