Occurrence of death during anaesthesia for surgery in Switzerland. The ADS project

TitreOccurrence of death during anaesthesia for surgery in Switzerland. The ADS project
Publication TypeConference Paper
Year of Publication2012
AuthorsSchulthess, Z, Sansonnes, J, Pittet, V, Moret, V, Burnand, B
Corporate AuthorsADS study Group
Conference Name60 Jahre Schweizerische Gesellschaft für Anästhesiologie und Reanimation SGAR und 40 Jahre Schweizerische Gesellschaft für Intensivmedizin SGI
Date Published2012
PublisherSchweiz Med Forum 2012;12(Suppl. 59) 7 S
Conference LocationBasel, 15.–17. November 2012

Introduction: Deaths occurring during anaesthesia for surgery is very rare and, therefore, seldom studied. Using the Anaesthesia Database Switzerland (ADS), we aimed to estimate the incidence of deaths occurring during anaesthesia for surgery in Switzerland, to describe the correlates of thereof, and to compare the results with data from the literature.

Methods: Using the ADS database, we analysed information prospectively and routinely collected during all anaesthesia for surgery in 28 Swiss hospitals from 1 January 2000 to 31 December 2009. We checked data quality regarding deaths by asking for confirmation to hospitals for each case. We used descriptive and stratified analyses.

Results: Among the 729’307 anaesthesias considered, 122 deaths were recorded. The crude death rate was 1.67/10’000 cases (CI 95% 1.38–1.97/10’000). Among death cases, 62.3% were men (46.6% of living patients). The number of deaths increased with age; the category 16–35 years of age were overrepresented. An ASA index >3 was found in 70.3% of deceased patients. Surgery occurred during an emergency intervention in 71.3% of patients who died vs. 18.5% of living patients. Duration of anaesthesia and surgery were longer in patients who died. Cases occurred predominantly during major general, vascular and major cardiac surgery. Most of dead patients (94.3%) presented at least one comorbidity, particularly cardiovascular (62.2%). Cardiovascular complications occurring during anaesthesia were the most frequent, in 82.6% of cases.

Discussion: This study shows that the observed trends and associations were to be expected. This indicates that the majority of deaths occurring during anaesthesia for surgery were mostly linked to patient characteristics, case severity, comorbidities, and type of surgery. The comparison with published data indicates a lower crude incidence rate in the Swiss study, with similar correlates with potential determinants of death. The main limitation of the study is the limited number of cases to evaluate the risks and correlates of deaths occurring during anaesthesia. Routinely collected data (i.e., the ADS project) are useful to monitor quality of anaesthesia care.



Citation Key / SERVAL ID6573


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