Luce V, Auroy Y, Ausset S, Luci P, Velay H, Benhamou D
Département d'anesthésie-réanimation, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, BP 405, 92141 Clamart cedex, France.
Ann Fr Anesth Reanim. 2004 Aug;23(8):788-93. doi: 10.1016/j.annfar.2004.06.008.
In order to evaluate the benefits arising from regular recording of intraoperative adverse events, we extracted from our database all episodes of intraoperative hypotension and studied the risk factors of this event.
Retrospective analysis of a large database from two university teaching hospitals evaluating the incidence and the risk factors of intraoperative hypotension by logistic regression.
A data collection chart describing the patient's characteristics, the anaesthetic technique and selected intraoperative incidents was filled for each anaesthetised patient in the operating room and then recorded in the computer database. Data collected in 2001 in patients undergoing general anaesthesia for orthopaedic and general surgery were reviewed and univariate and multivariate analysis were performed using Statview 5.0 and Stata 7.0.
Among 11 820 patients who underwent anaesthesia, 2691 were selected. The incidence of intraoperative arterial hypotension was 16.8%. The associated factors were duration of surgery, age and ASA status of the patients. The use of etomidate for induction was not associated with a decreased risk of intraoperative hypotension.
Systematic recording of intraoperative events in a database has been suggested as useful by many experts for quality-assurance and safety analysis purposes. Analysis of a frequent anaesthesia-related (i.e. hypotension) event did not disclose any relevant factor that might lead to improvement. Running such databases is time-consuming and may be expensive. This leads us to question the efficiency of such databases.
为了评估定期记录术中不良事件所带来的益处,我们从数据库中提取了所有术中低血压事件,并研究了该事件的风险因素。
对两家大学教学医院的大型数据库进行回顾性分析,通过逻辑回归评估术中低血压的发生率和风险因素。
为手术室中每位接受麻醉的患者填写一份描述患者特征、麻醉技术和选定术中事件的数据收集表,然后记录在计算机数据库中。回顾2001年接受骨科和普外科全身麻醉患者收集的数据,并使用Statview 5.0和Stata 7.0进行单因素和多因素分析。
在11820例接受麻醉的患者中,选取了2691例。术中动脉低血压的发生率为16.8%。相关因素为手术时间、患者年龄和美国麻醉医师协会(ASA)分级。使用依托咪酯诱导与术中低血压风险降低无关。
许多专家认为,在数据库中系统记录术中事件对于质量保证和安全分析是有用的。对一个常见的麻醉相关事件(即低血压)的分析未发现任何可能带来改善的相关因素。运行此类数据库既耗时又可能成本高昂。这使我们对这类数据库的效率产生质疑。