Perioperative Myocardial Ischemia / Infarction: Study of Incidents from Thai Anesthesia Incidence Study (THAI Study) of 163,403 Cases
Oraluxna Rodanant MD*, Thitima Chinachoti MD**, Thewarug Veerawatakanon MD*, Rasanee Charoenkul MD***, Wanna Somboonviboon MD*, Neerada Kojittavanit****
Affiliation : *Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University ** Department of Anesthesiology, Siriraj Hospital, Mahidol University *** Department of Anesthesiology, Trang Hospital **** Department of Anesthesiology, Banpong Hospital, Thailand
Objectives : To analyze incidence, risk factors, clinical course, outcomes of PMI. Degree of anesthesia related
to PMI, management, precipitating factors and corrective strategies.
Materials and Methods : PMI cases were extracted from the Thai Anesthesia Incidents Study (THAI Study)
database conducted between February 1,2003 and January 31,2004, and analyzed using descriptive statistics.
Results : Forty-five cases were recorded as PMI (Suspected myocardial ischemia/infarction) from 20 hospital
study centers. The incidence was 2.7:10,000 of all anesthetic services (163,403 cases). PMI occurred more
frequently in male, underlying disease of hypertension, diabetes mellitus, ischemic heart disease, ASA class >2,
under general anesthesia and during operation. EKG change and hypotension were primary clinical symp-
toms. PMI caused high mortality (5 cases), high morbidity (6 cases of brain death), high medical cost and
change of management plan.
Conclusion : PMI was strongly impact to both anesthetic and surgical outcomes. Improve quality of anesthetic
care for patient at risk and surgical risk reflected the whole anesthetic quality of care.
Keywords : Myocardial ischemia, Myocardial infarction, Anesthesia, Complication, Adverse events
