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    Anesthesia Much Safer than in 1950s

    By Jennifer Huddleston, staff writer     

    Researchers at Columbia University in New York City and the National Center of Health Statistics concluded that the anesthesia-related mortality rate is .11 deaths per 100,000 patients, according to a report in the January 2009 edition of Anesthesiology News.

    “In the 1950s, the reported mortality risk from anesthesia was about one in 1,000 patients, which decreased to about one in 10,000, and is now down to about one in 100,000 patients,” said Guohua Li, Ph.D., M.D., lead researcher in the study.

    A 1974 review in the journal Clinical Anesthesia estimated that at the time, there were more than 5,000 anesthesia-related deaths annually in the U.S.
    [2] Now approximately 323 deaths across the country are attributed to anesthesia complications each year. [3]

    According to an American Society of Anesthesiologists (ASA) Annual Meeting Abstract, the purpose of Li’s study was to create standard anesthesia safety indicators based on the International Classification of Diseases (ICD) codes and apply those to a national data system in order to understand the pattern of deaths related to anesthesia.

    The study is the first of its kind in approximately 30 years. Previous research has been confined to data from specific hospitals, closed cases and case reports.

    Li and his colleagues analyzed patient safety indicators from the U.S. Department of Health and Human Services Agency for Research and Quality and screened manuals for all ICD codes related to anesthesia and anesthetics.

    The study included seven years of data, in which 46 codes related to anesthesia or anesthetics were discovered and 2,211 anesthesia-related deaths were recorded. The researchers divided the 46 codes into four categories: complications of anesthesia related to pregnancy or labor and delivery; overdose of anesthetics; adverse effects of anesthetics; and other complications, including malignant hyperthermia due to anesthesia.

    Of the 2,211 reported anesthesia-related deaths, almost half (47 percent) were due to an overdose of anesthetics and another 42 percent were attributed to adverse effects of anesthetics. When calculated by gender and age, Li’s team found that the anesthesia-related mortality rate for men was about twice the rate for women and that the risk for both men and women increased dramatically after age 65.

    The researchers concluded that the 46 ICD codes identified in the study are suitable for use as anesthesia safety indicators that can be applied to national health information systems in order to monitor anesthesia-related mortality and morbidity.

    It is likely that as more medical advances are achieved, anesthesia-related deaths will continue to decline in the U.S.

    [1] Vlessides, Michael. “Study Confirms Anesthesia Safety.” Anesthesiology News. January 2009.
    [2] Phillips, O.C., Capizzi, L.S. “Anesthesia Mortality.” Clinical Anesthesia . 1974;10(3):220-44. Review.
    [3] Li, Guohua, et al. “Epidemiology of Anesthesia-Related Deaths in the United States, 1999-2004.” ASA Abstract A845. Oct. 20, 2008. 

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