Vascular anaesthesia was associated with an estimated peri-operative cardiac arrest incidence of 1 in 670 cases, with major haemorrhage as the leading cause and a 70% mortality rate.
Cohort (n=69)
Yes
What is the incidence, cause, and outcome of peri-operative cardiac arrest in patients undergoing vascular surgery?
Peri-operative cardiac arrest during vascular surgery is a rare but highly lethal event, most commonly caused by major haemorrhage during non-elective procedures.
Effect estimate: Incidence 1 in 670 (95% CI 1 in 520-830)
The 7th National Audit Project of the Royal College of Anaesthetists studied peri-operative cardiac arrest in the UK. We report the results of the vascular surgery cohort from the 12-month case registry, from 16 June 2021 to 15 June 2022. Anaesthesia for vascular surgery accounted for 2% of UK anaesthetic caseload and included 69 (8%) reported peri-operative cardiac arrests, giving an estimated incidence of 1 in 670 vascular anaesthetics (95%CI 1 in 520-830). The high-risk nature of the vascular population is reflected by the proportion of patients who were ASA physical status 4 (30, 43%) or 5 (19, 28%); the age of patients (80% aged > 65 y); and that most cardiac arrests (57, 83%) occurred during non-elective surgery. The most common vascular surgical procedures among patients who had a cardiac arrest were: aortic surgery (38, 55%); lower-limb revascularisation (13, 19%); and lower-limb amputation (8, 12%). Among patients having vascular surgery and who had a cardiac arrest, 28 (41%) presented with a ruptured abdominal aortic aneurysm. There were 48 (70%) patients who had died at the time of reporting to NAP7 and 11 (16%) were still in hospital, signifying poorer outcomes compared with the non-vascular surgical cohort. The most common cause of cardiac arrest was major haemorrhage (39, 57%), but multiple other causes reflected the critical illness of the patients and the complexity of surgery. This is the first analysis of the incidence, management and outcomes of peri-operative cardiac arrest during vascular anaesthesia in the UK.
Armstrong et al. (Thu,) conducted a cohort in Peri-operative cardiac arrest during vascular surgery (n=69). Vascular anaesthesia vs. Non-vascular surgical cohort was evaluated on Incidence of peri-operative cardiac arrest (Incidence 1 in 670, 95% CI 1 in 520-830). Vascular anaesthesia was associated with an estimated peri-operative cardiac arrest incidence of 1 in 670 cases, with major haemorrhage as the leading cause and a 70% mortality rate.