The Thai anesthesia incidents study (THAI study) of perioperative death in geriatric patients

Abstract

Background: The study was part of the Thai Anesthesia Incidents Study (THAI Study), a multi-centered study conducted by the Royal College of Anesthesiologists of Thailand, aiming to survey anesthetic related complications in Thailand. Objective: Identify the incidence and factors related to perioperative death in geriatric patients. Material and Method: During a 12 months period (March 1, 2003 - February 28, 2004), a prospective multicenter descriptive study conducted in 20 hospitals comprising of seven university, five tertiary, four general and four district hospitals across Thailand. Anesthesia personnel filled up patient-related data, surgical-related, and anesthesia related variables and adverse outcomes of geriatric patients (age ≥ 65 yr) on a structured data entry form. The data were collected during pre-anesthetic, intra-operative, and 24 hr post operative periods. Results: The overall mortality was 39.3 per 10,000 anesthetics from the registry of 23,899 geriatric patients receiving anesthesia. Multiple regression analysis showed that higher American Society of Anesthesiologists (ASA) physical status grading (p < 0.001), emergency operation (p = 0.031) and current medications (p = 0.043) were factors related to 24 hr perioperative death in geriatric patients. Patient's underlying diseases and duration of operations were not significantly related to death. Conclusion: The present study showed an incidence of 24-hr perioperative death of 1: 254 in geriatric patients receiving anesthesia, which is comparable to other countries. Mortality in elderly patients operated under anesthesia can be predicted by ASA physical status, current medications, and emergency condition.