Perioperative myocardial ischemia/infarction: study of incidents from Thai Anesthesia Incidence Study (THAI Study) of 163,403 cases.

OBJECTIVES To analyze incidence, risk factors, clinical course, outcomes of PMI. Degree of anesthesia related to PMI, management, precipitating factors and corrective strategies. MATERIAL AND METHOD 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 symptoms. 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.