Old Complications Rising Words

Old Complications on the Rise:
Anesthesiologists, Are we as good as we think?

[Will post in full after published in Anesthesiology News]

Despite vast improvements in surgical and anesthetic practice, a new trio of studies makes it appear that anesthesiology may have a ways to go. Advances in technology have seemingly contributed to increases in old anesthesia-related complications. At least, that's what these findings—highlighted by three abstracts presented in March at the International Anesthesia Research Society's (IARS) 81rst Congress—would initially suggest.

The abstracts, each based on a database of more than 37,000,000 patients assembled by the Agency for Healthcare Research and Quality (AHRQ), discussed rising trends in three areas: postoperative respiratory failure (PORF), anesthetic complications, and postoperative septic shock (POSS). The first complication, PORF, actually doubled from 1994 to 2003, increasing from two to four percent.

“We would not have anticipated an increase in PORF, let alone one so pronounced,” said this study’s lead author, Mark Nunnally, MD, an anesthesiologist at The University of Chicago, where all three studies were based. “Our effort now is directed at uncovering as much as we can about why this finding exists in a database this size.”

Recent investigations have associated increased PORF with age; patients over 45 are more susceptible. Other contributing factors have included patient incomes below $25,000, care from non-metropolitan hospitals, and use of Medicare or Medicaid versus private insurance.

As anesthesiologists consider why PORF and other old complications are getting worse, one point seems clear: surgical and anesthetic techniques are not to blame...


.MGW.