The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports

Background: The present study is part of the multicenter study of model of anesthesia related adverse events in Thailand by Incident Report (The Thai Anesthesia Incident Monitoring Study or Thai AIMS). The objectives of the present study were to determine the frequency, clinical presenting, and outc...

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Main Authors: Chularojmontri T., Kositanurit I., Charuluxananan S., Sriraj W., Punjasawadwong Y., Pulnitiporn A.
Format: Article
Language:English
Published: 2014
Online Access:http://www.scopus.com/inward/record.url?eid=2-s2.0-79251536494&partnerID=40&md5=d4a78854c47b87660e261044e230d7ca
http://cmuir.cmu.ac.th/handle/6653943832/3803
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spelling th-cmuir.6653943832-38032014-08-30T02:35:20Z The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports Chularojmontri T. Kositanurit I. Charuluxananan S. Sriraj W. Punjasawadwong Y. Pulnitiporn A. Background: The present study is part of the multicenter study of model of anesthesia related adverse events in Thailand by Incident Report (The Thai Anesthesia Incident Monitoring Study or Thai AIMS). The objectives of the present study were to determine the frequency, clinical presenting, and outcomes of suspected pulmonary embolism. Material and Method: The present study is a prospective descriptive research design. Three anesthesiologists extracted relevant data from the incident reports on suspected pulmonary embolism from the Thai AIMS database collected during the study period between January 1 and June 30, 2007. Descriptive statistics was used. Results: After exclusion of four irrelevant or unlikely pulmonary embolism patients, there were 12 cases of suspected pulmonary embolism (0.6% of 1996 incident reports). Four cases (25%) were operated under emergency conditions. One incident (8.3%), eight incidents (67.7%), and three incidents (25%) were diagnosed by clinical diagnosis in preoperative, intra-operative, and 24-hour postoperative period. Common clinical manifestations were hypoxia (91.7%), hypotension (91.7%), and cardiac arrest (50%) at time of diagnosis. The mortality rate of obstetric surgery, orthopedic surgery, and general surgery were 42.8% (3 out of 7), 50% (2 out of 4), and 0% (0 out of 1 patient) with a total mortality rate of 41.7%. Only two patients (16.6%) that had incidental cardiac arrest survived. There were two cases (16.6%) of preventable incidents due to incorrect usage of pressure pump for rapid IV infusion. Conclusion: Diagnosis of pulmonary embolism was difficult. The incidents were rare. Hypoxia and hypotension were the most common manifestations. Perioperative mortality rate was high (41.7%) despite prompt cardiopulmonary support. Most incidents were unexpected. An air embolism due to incorrect use of pressure pump for rapid IV infusion was considered preventable. Further epidemiologic studies for thromboembolism prophylaxis in Thailand are needed. 2014-08-30T02:35:20Z 2014-08-30T02:35:20Z 2011 Article 1252208 21425733 JMTHB http://www.scopus.com/inward/record.url?eid=2-s2.0-79251536494&partnerID=40&md5=d4a78854c47b87660e261044e230d7ca http://cmuir.cmu.ac.th/handle/6653943832/3803 English
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
language English
description Background: The present study is part of the multicenter study of model of anesthesia related adverse events in Thailand by Incident Report (The Thai Anesthesia Incident Monitoring Study or Thai AIMS). The objectives of the present study were to determine the frequency, clinical presenting, and outcomes of suspected pulmonary embolism. Material and Method: The present study is a prospective descriptive research design. Three anesthesiologists extracted relevant data from the incident reports on suspected pulmonary embolism from the Thai AIMS database collected during the study period between January 1 and June 30, 2007. Descriptive statistics was used. Results: After exclusion of four irrelevant or unlikely pulmonary embolism patients, there were 12 cases of suspected pulmonary embolism (0.6% of 1996 incident reports). Four cases (25%) were operated under emergency conditions. One incident (8.3%), eight incidents (67.7%), and three incidents (25%) were diagnosed by clinical diagnosis in preoperative, intra-operative, and 24-hour postoperative period. Common clinical manifestations were hypoxia (91.7%), hypotension (91.7%), and cardiac arrest (50%) at time of diagnosis. The mortality rate of obstetric surgery, orthopedic surgery, and general surgery were 42.8% (3 out of 7), 50% (2 out of 4), and 0% (0 out of 1 patient) with a total mortality rate of 41.7%. Only two patients (16.6%) that had incidental cardiac arrest survived. There were two cases (16.6%) of preventable incidents due to incorrect usage of pressure pump for rapid IV infusion. Conclusion: Diagnosis of pulmonary embolism was difficult. The incidents were rare. Hypoxia and hypotension were the most common manifestations. Perioperative mortality rate was high (41.7%) despite prompt cardiopulmonary support. Most incidents were unexpected. An air embolism due to incorrect use of pressure pump for rapid IV infusion was considered preventable. Further epidemiologic studies for thromboembolism prophylaxis in Thailand are needed.
format Article
author Chularojmontri T.
Kositanurit I.
Charuluxananan S.
Sriraj W.
Punjasawadwong Y.
Pulnitiporn A.
spellingShingle Chularojmontri T.
Kositanurit I.
Charuluxananan S.
Sriraj W.
Punjasawadwong Y.
Pulnitiporn A.
The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports
author_facet Chularojmontri T.
Kositanurit I.
Charuluxananan S.
Sriraj W.
Punjasawadwong Y.
Pulnitiporn A.
author_sort Chularojmontri T.
title The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports
title_short The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports
title_full The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports
title_fullStr The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports
title_full_unstemmed The Thai incident monitoring study (Thai AIMS) of suspected pulmonary embolism: An analysis of 1,996 incident reports
title_sort thai incident monitoring study (thai aims) of suspected pulmonary embolism: an analysis of 1,996 incident reports
publishDate 2014
url http://www.scopus.com/inward/record.url?eid=2-s2.0-79251536494&partnerID=40&md5=d4a78854c47b87660e261044e230d7ca
http://cmuir.cmu.ac.th/handle/6653943832/3803
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