Claims for recall during general anesthesia were more likely in women (OR 3.08; 95% CI 1.58-6.06) and with techniques using opioids, muscle relaxants, and no volatile anesthetic.
Observational (n=4,183)
Sí
What patient and anesthetic factors are associated with malpractice claims for intraoperative awareness during general anesthesia?
Malpractice claims for recall during general anesthesia are significantly associated with female sex and the use of nitrous-narcotic-relaxant techniques without volatile anesthetics.
Estimación del efecto: OR 3.08 (95% CI 1.58-6.06)
BACKGROUND: Awareness during general anesthesia is a frightening experience, which may result in serious emotional injury and post-traumatic stress disorder. We performed an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project to explore the contribution of intraoperative awareness to professional liability in anesthesia. METHODS: The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims for intraoperative awareness were reviewed by the reviewers to identify patterns of causation and standard of care. Logistic regression analysis was used to identify independent patient and anesthetic factors associated with claims for recall during general anesthesia compared to other general anesthesia malpractice claims. RESULTS: Awareness claims accounted for 79 (1.9%) of 4,183 claims in the database, including 18 claims for awake paralysis, i.e., the inadvertent paralysis of an awake patient, and 61 claims for recall during general anesthesia, ie., recall of events while receiving general anesthesia. The majority of awareness claims involved women (77%), younger than 60 yr of age (89%), American Society of Anesthesiologists physical class I-II (68%), who underwent elective surgery (87%). Most (94%) claims for awake paralysis represented substandard care involving errors in labeling and administration, whereas care was substandard in only 43% of the claims for recall during general anesthesia (P < 0.001). Claims for recall during general anesthesia were more likely to involve women (odds ratio OR = 3.08, 95% confidence interval CI = 1.58, 6.06) and anesthetic techniques using intraoperative opioids (OR = 2.12, 95% CI = 1.20, 3.74), intraoperative muscle relaxants (OR = 2.28, 95% CI = 1.22, 4.25), and no volatile anesthetic (OR = 3.20, 95% CI = 1.88, 5.46). CONCLUSIONS: Deficiencies in labeling and vigilance were common causes for awake paralysis. Claims for recall during general anesthesia were more likely in women and with nitrous-narcotic-relaxant techniques.
Domino et al. (Thu,) conducted a observational in Intraoperative awareness (n=4,183). Patient and anesthetic factors vs. Other general anesthesia malpractice claims was evaluated on Claims for recall during general anesthesia (association with female sex) (OR 3.08, 95% CI 1.58-6.06). Claims for recall during general anesthesia were more likely in women (OR 3.08; 95% CI 1.58-6.06) and with techniques using opioids, muscle relaxants, and no volatile anesthetic.
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