Costs Associated with Anesthesia-Related Adverse Events During Labor and Delivery in New York State, 2010

Hunt, Tristan; Guglielminotti, Jean; Li, Guohua

doi:10.1213/ane.0000000000001291

Cited by 8 publications

(2 citation statements)

References 25 publications

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“…Given their diversity, HCUP datasets can be used to address a broad range of perioperative questions. Studies have, for example, investigated pulmonary complications after hip and knee arthroplasty in the United States, 48 the incidence of intraoperative cardiac arrest, 10 costs associated with anesthesia-related adverse events during labor and delivery in New York State, 12 and the association between payer status and mortality/morbidity rate after inpatient shoulder arthroplasty. 13 The HCUP series of datasets are relatively inexpensive, are clean (requiring limited data management), and represent the largest collection of longitudinal hospital care data in the Unites States with high reliability.…”

Section: Ofmentioning

confidence: 99%

An Overview of Commonly Used Data Sources in Observational Research in Anesthesia

Zhong

Thor

Illescas

et al. 2022

Anesthesia &Amp; Analgesia

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Anesthesia research using existing databases has drastically expanded over the last decade. The most commonly used data sources in multi-institutional observational research are administrative databases and clinical registries. These databases are powerful tools to address research questions that are difficult to answer with smaller samples or single-institution information. Given that observational database research has established itself as valuable field in anesthesiology, we systematically reviewed publications in 3 high-impact North American anesthesia journals in the past 5 years with the goal to characterize its scope. We identified a wide range of data sources used for anesthesia-related research. Research topics ranged widely spanning questions regarding optimal anesthesia type and analgesic protocols to outcomes and cost of care both on a national and a local level. Researchers should choose their data sources based on various factors such as the population encompassed by the database, ability of the data to adequately address the research question, budget, acceptable limitations, available data analytics resources, and pipeline of follow-up studies.

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Section: Ofmentioning

confidence: 99%

An Overview of Commonly Used Data Sources in Observational Research in Anesthesia

Zhong

Thor

Illescas

et al. 2022

Anesthesia &Amp; Analgesia

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“…While we have several studies on critical incidents during anesthesia in high-income countries [ 4 – 6 ], there is very limited information available about these incidents, as well as healthcare-related harm, occurring in low- and middle-income counties [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Critical incidents during anesthesia: prospective audit

Bielka,

Kuchyn,

Frank

et al. 2023

BMC Anesthesiol

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Background Critical incident reporting and analysis is one of the key components of patient safety in anesthesiology. The aim of this study was to determine the frequency and characteristics of critical incidents during anesthesia, main causes and factors involved, influence on patient outcomes, prevalence of incident reporting and further analysis. Methods A multicenter prospective audit was conducted at the clinical departments of the Bogomolets National Medical University during the period from 1 to 2021 to 1 December 2021. 13 hospitals from different Ukrainian regions took part in the study. Anesthesiologists voluntarily submitted critical incident reports into a Google form as they occurred during the working shifts, reporting the details of the incident, and the incident registration routine in their hospital. The study design was approved by the Bogomolets National Medical University (NMU) ethics committee, protocol #148, 07.09.2021. Results The incidence of critical incidents was 9.35 cases per 1000 anesthetic procedures. Most common incidents were related to the respiratory system: difficult airway (26.8%), reintubation (6.4%), oxygen desaturation (13.8%); cardiovascular system: hypotension (14.9%), tachycardia (6.4%), bradycardia (11.7%), hypertension (5.3%), collapse (3.2%); massive hemorrhage (17%). Factors associated with critical incidents were elective surgery (OR 4.8 [3.1–7.5]), age from 45 to 75 years (OR 1.67 [1.1–2.5]), ASA II (OR 38 [13–106]}, III (OR 34 [12–98]) or IV (3.7 [1.2–11]) compared to ASA I; regional anesthesia (OR 0.67 95 CI 0.5–0.9) or general anesthesia (GA) and regional anesthesia combination (OR 0.55 95 CI 0.3–0.9] decreased the risk of incidents compared to GA alone. Procedural sedation was associated with increased risk of a critical incident, compared to GA (OR 0.55 95 CI 0.3–0.9). The incidents occurred most commonly during the maintenance phase (75/113, 40%, OR compared to extubation phase 20 95 CI 8–48) or the induction phases of anesthesia (70/118, 37%, OR compared to extubation phase 18 95 CI 7–43). Among common reasons that could lead to the incident, the physicians have identified: individual patient features (47%), surgical tactics (18%), anesthesia technique (16%) and human factor (12%). The most frequent failings contributing to the incident occurrence were: insufficient preoperative assessment (44%), incorrect interpretation of the patients’ state (33%), faulty manipulation technique (14%), miscommunication with a surgical team (13%) and delay in emergency care (10%). Furthermore, 48% of cases, as judged by participating physicians, were preventable and the consequences of another 18% could be minimized. The consequences of the incidents were insignificant in over a half of the cases, but in 24.5% have led to prolonged hospital stay, in 16% patients required an urgent transfer to the ICU and 3% of patients died during their hospital stay. The majority of the critical incidents (84%) were reported through the hospital reporting system, using mostly paper forms (65%), oral reports (15%) and an electronic database (4%). Conclusion Critical incidents during anesthesia occur rather often, mainly during the induction or maintenance phases of anesthesia, and could lead to prolonged hospital stay, unplanned transfer to the ICU or death. Reporting and further analysis of the incident are crucial, so we should continue to develop the web-based reporting systems on both local and national levels. Study registration NCT05435287, clinicaltrials.gov, 23/6/2022.

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Anaesthesia-related AEs during childbirth costly

2016

PharmacoEcon Outcomes News

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Costs Associated with Anesthesia-Related Adverse Events During Labor and Delivery in New York State, 2010

Abstract: ARAEs during labor and delivery are associated with significant excess cost. However, the excess cost per admission for ARAEs is significantly less compared with the excess cost per admission for preeclampsia/eclampsia and postpartum hemorrhage.

Cited by 8 publications

References 25 publications

An Overview of Commonly Used Data Sources in Observational Research in Anesthesia

An Overview of Commonly Used Data Sources in Observational Research in Anesthesia

Critical incidents during anesthesia: prospective audit

Anaesthesia-related AEs during childbirth costly

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