Highest Risk for Anesthesia Mortality among Older and Multimorbid Patitents
Posted Jul 25 2011 12:00am
Is general itself anesthesia dangerous? It depends, in part, on your age and co-morbidities when you undergo an operation (see: Is anesthesia dangerous? ). I have always been interested in the mortality rate of general anesthesia but the numbers have been hard for me to find until now. Below is an excerpt from an article on this topic:
In pure numerical terms, anesthesia-associated mortality has risen again. The reasons for this are the disproportionate increase in the numbers of older and multimorbid patients and surgical procedures that would have been unthinkable in the past. This is the result of a selective literature review of André Gottschalk's working group at the Bochum University Hospital....In the 1940s, anesthesia-related mortality was 6.4/10,000. By introducing safety standards such as pulse oximetry and capnometry, the rate was reduced to 0.4/100,000 by the late 1980s. This value still applies for patients without relevant systemic disease. However, mortality has risen in patients with relevant comorbidities (0.69/100,000). Such comorbidities include heart failure, angina pectoris, chronic renal failure, or severe malignant hypertension. Because of improved safety standards such patients can have surgery nowadays—something that would have been unthinkable in the past owing to their multimorbidity. Another factor explaining anesthesia-related mortality is the fact that the proportion of patients who are older than 65 rose in Germany from 28.8% in 2005 to 40.9% in 2009.
Here are a couple of definitions that may help you understand this article:
: a medical device that indirectly monitors the oxygen saturation of a patient's blood and changes in blood volume in the skin, producing a photoplethysmograph.
: the monitoring of the concentration or partial pressure of carbon dioxide (CO2) in the respiratory gases. Its main development has been as a monitoring tool for use during anaesthesia and intensive care.
The challenge for anesthesiologists is not going to get any easier in the future. The U.S. population is certainly getting older and the rate of obesity and other chronic health diseases is rising (see: Breast Surgery Proves Riskier for Obese Women ). However, anthesiologists have risen to similar challenges over the years. I can only assume that they will continuously improve their record of keeping obese, older, and multimorbid patients breathing under general anesthesia as their experience with such patients broadens.