Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16573
Title: Safety of sedation for gastrointestinal endoscopy in a group of university-affiliated hospitals: a prospective cohort study
Austin Authors: Leslie, Kate;Allen, ML;Hessian, EC;Peyton, Philip J ;Kasza, J;Courtney, A;Dhar, PA;Briedis, J;Lee, S ;Beeton, AR;Sayakkarage, D;Palanivel, S;Taylor, JK;Haughton, AJ;O'Kane, CX
Affiliation: Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Anaesthesia, Perioperative and Pain Medicine Unit, University of Melbourne, Melbourne, Victoria, Australia
Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Cancer Anaesthesia, Pain and Perioperative Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Department of Anaesthesia and Pain Medicine, Western Hospital, Melbourne, Victoria, Australia
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
Department of Anaesthesia and Perioperative Medicine, Northern Hospital, Melbourne, Victoria, Australia
Department of Anaesthesia, Goulburn Valley Base Hospital, Shepparton, Victoria, Australia
Department of Anaesthesia, Ballarat Base Hospital, Ballarat, Victoria, Australia
Department of Anaesthesia, St Vincent's Hospital, Melbourne, Victoria, Australia
Department of Anaesthesia, Wangaratta Base Hospital, Wangaratta, Victoria, Australia
Issue Date: 30-Dec-2016
Date: 2016-12-30
Publication information: British Journal of Anaesthesia 2016; 118(1): 90-99
Abstract: BACKGROUND: Service models for gastrointestinal endoscopy sedation must be safe, as endoscopy is the most common procedure performed under sedation in many countries. The aim of this prospective cohort study was to determine the patient risk profile, and incidence of and risk factors for significant unplanned events, in adult patients presenting for gastrointestinal endoscopy in a group of university-affiliated hospitals where most sedation is managed by anaesthetists. METHODS: Patients aged ≥18 yr presenting for elective and emergency gastrointestinal endoscopy under anaesthetist-managed sedation at nine hospitals affiliated with the University of Melbourne, Australia, were included. Outcomes included significant airway obstruction, hypoxia, hypotension and bradycardia; unplanned tracheal intubation; abandoned procedure; advanced life support; prolonged post-procedure stay; unplanned over-night admission and 30-day mortality. RESULTS: 2,132 patients were included. Fifty percent of patients were aged >60 yr, 50% had a BMI >27 kg m -2, 42% were ASA physical status III-V and 17% were emergency patients. The incidence of significant unplanned events was 23.0% (including significant hypotension 11.8%). Significant unplanned intraoperative events were associated with increasing age, BMI <18.5 kg m -2, ASA physical status III-V, colonoscopy and planned tracheal intubation. Thirty-day mortality was 1.2% (0.2% in electives and 6.0% in emergencies) and was associated with ASA physical status IV-V and emergency status. CONCLUSIONS: Patients presenting for gastrointestinal endoscopy at a group of public university-affiliated hospitals where most sedation is managed by anaesthetists, had a high risk profile and a substantial incidence of significant unplanned intraoperative events and 30-day mortality.
URI: https://ahro.austin.org.au/austinjspui/handle/1/16573
DOI: 10.1093/bja/aew393
Journal: British Journal of Anaesthesia
PubMed URL: 28039246
Type: Journal Article
Subjects: Anaesthesia
Complications
Gastrointestinal endoscopy
Sedation
Appears in Collections:Journal articles

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