Kakavouli Athina, Li Guohua, Carson Margaret P, Sobol Julia, Lin Christine, Ohkawa Susumu, Huang Lin, Galiza Carolyn, Wood Alastair, Sun Lena S
Department of Anesthesiology, Columbia University, New York, NY 10032, USA.
Paediatr Anaesth. 2009 Aug;19(8):732-9. doi: 10.1111/j.1460-9592.2009.03066.x.
Significant intraprocedural adverse events (AE) are reported in children who receive anesthesia for procedures outside the Operating Rooms (NORA). No study, so far, has characterized AE in children who receive anesthesia in the operating rooms (ORA) and NORA when anesthesia care is provided by the same team in a consistent manner.
OBJECTIVE/AIM: We used the same patient-specific Quality Assurance questionnaires (QAs), to elucidate incidences of intraoperative reported AE for children receiving anesthesia in NORA and ORA locations. Through multivariate logistic regression analysis, we assessed the association between patient's AE risk and procedure's location while adjusting for American Society of Anesthesiologists (ASA) status, age, and unscheduled nature of the procedure.
METHODS/MATERIALS: After Institutional Review Board approval, we used returned QAs of patients under 21 years, who received anesthesia from our pediatric anesthesia faculty from May 1 2006 through September 30, 2007. We analyzed QA data on: service location, unscheduled/scheduled procedure, age, ASA status, presence, and type of AE. We excluded QAs with incomplete information on date, location, age, and ASA status.
We included 8707 cases, with 3.5% incidence of reported AE. We had 1898 NORA and 6808 ORA cases with AE incidence of 2.5% and 3.7%, respectively. Multivariate regression analysis revealed that patients with higher ASA status or younger age had higher incidence of reported AE, irrespective of location or unscheduled nature of the procedure. The most common AE type, for both sites, was respiratory related (1.9%).
Pediatric reported AE incidence was comparable for NORA and ORA locations. Younger age or higher ASA status are associated with increased risk of AE.
据报道，在手术室以外接受麻醉的儿童中会出现严重的术中不良事件（AE）。迄今为止，尚无研究对在手术室（ORA）和手术室以外（NORA）接受麻醉的儿童的不良事件进行特征描述，且这些麻醉护理均由同一团队以一致的方式提供。
我们使用相同的针对患者的质量保证问卷（QA），以阐明在NORA和ORA接受麻醉的儿童术中报告的不良事件发生率。通过多因素逻辑回归分析，我们评估了患者不良事件风险与手术地点之间的关联，同时对美国麻醉医师协会（ASA）状态、年龄和手术的非计划性进行了校正。
方法/材料：经机构审查委员会批准后，我们使用了2006年5月1日至2007年9月30日期间从我们儿科麻醉科接受麻醉的21岁以下患者返还的QA。我们分析了关于服务地点、非计划性/计划性手术、年龄、ASA状态、不良事件的存在及类型的QA数据。我们排除了在日期、地点、年龄和ASA状态方面信息不完整的QA。
我们纳入了8707例病例，报告的不良事件发生率为3.5%。我们有1898例NORA病例和6808例ORA病例，不良事件发生率分别为2.5%和3.7%。多因素回归分析显示，无论手术地点或是否为非计划性手术，ASA状态较高或年龄较小的患者报告的不良事件发生率较高。两个地点最常见的不良事件类型均为呼吸相关（1.9%）。
儿科报告的NORA和ORA地点的不良事件发生率相当。年龄较小或ASA状态较高与不良事件风险增加相关。
