title: Intraoperative cardiac arrest and mortality in trauma patients. A 14-yr survey from a Brazilian tertiary teaching hospital.
abstract: BACKGROUND
  Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009.
  
  
  METHODS
  Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related.
  
  
  RESULTS
  Fifty-one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (P<0.001) and young adults (18-35 years) (P=0.04) with ASA physical status IV or V (P<0.001) undergoing gastroenterological or multiclinical surgeries (P<0.001). Motor vehicle crashes and violence were the main causes of trauma (P<0.001). Uncontrolled hemorrhage or head injury were the most significant associated factors of intraoperative cardiac arrest and mortality (P<0.001). All cardiac arrests and deaths reported were totally related to trauma patient condition.
  
  
  CONCLUSIONS
  Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence.
authors.affiliation: Department of Anesthesiology, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: Marcelo T O
authors.initials: MT
authors.lastname: Carlucci
authors.affiliation: Department of Anesthesiology, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: José R C
authors.initials: JR
authors.lastname: Braz
authors.affiliation: Department of Anesthesiology, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: do Nascimento
authors.affiliation: Department of Biostatistics, Institute of Biosciences, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: Lidia R
authors.initials: LR
authors.lastname: de Carvalho
authors.affiliation: Department of Anesthesiology, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: Yara M M
authors.initials: YM
authors.lastname: Castiglia
authors.affiliation: Department of Anesthesiology, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: Leandro G
authors.initials: LG
authors.lastname: Braz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality*; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance; D062606:Tertiary Care Centers; D014947:Wounds and Injuries / Q000150:complications* / Q000209:etiology / Q000601:surgery; D055815:Young Adult