title: Rate of Major Anesthetic-Related Outcomes in the Intraoperative and Immediate Postoperative Period After Cardiac Surgery.
abstract: OBJECTIVE
  To examine anesthesia-centered outcomes in a large cohort of patients undergoing coronary artery bypass grafting (CABG) or valvular heart surgery.
  
  
  METHODS
  A retrospective study with univariate and multivariate logistic regression to identify independent predictors for mortality.
  
  
  METHODS
  Diverse setting including university, small, medium, and large community hospitals.
  
  
  METHODS
  All patients undergoing CABG or valve surgery in the National Anesthesia Clinical Outcomes Registry (NACOR) from the Anesthesia Quality Institute.
  
  
  METHODS
  None.
  
  
  RESULTS
  Common anesthesia-centered outcomes including arrhythmia, cardiac arrest, death, hemodynamic instability, hypotension, inadequate pain control, nausea/vomiting, seizure, stroke, reintubation and transfusion were reported. All outcomes, consistent with NACOR data entry, were defined as occurring intraoperatively or during phase I or II recovery in the PACU. Death occurred in 0.15% of CABGs and 0.23% of valve surgeries. Age less than 18, American Society of Anesthesiologists physical status (ASA PS) classification of 5, and mean case duration greater than 6 hours were associated with increased mortality (p<0.05). The presence of a board-certified anesthesiologist was associated with decreased odds for mortality.
  
  
  CONCLUSIONS
  Death was a rare outcome in this cohort, reflecting the infrequent occurrence of intraoperative or immediate postoperative death. The presence of a board-certified anesthesiologist represented a modifiable risk factor for reducing mortality risk.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Ethan Y
authors.initials: EY
authors.lastname: Brovman
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Gabriel
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Lekowski
authors.affiliation: Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Dutton
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA; Anesthesia Quality Institute, Schaumburg, IL. Electronic address: rurman@partners.org.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects* / Q000401:mortality*; D000072080:Anesthesiologists; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D005260:Female; D006351:Heart Valves / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: CABG; anesthesiology; cardiac surgery; mortality; outcomes; valve surgery