Association between preoperative characteristics and risk of anaesthesia-related death in dogs in small-animal referral hospitals in Japan. (May 2017)

• Record Type: Journal Article
• Authors: Itami, Takaharu; Aida, Hiroko; Asakawa, Makoto; Fujii, Yoko; Iizuka, Tomoya; Imai, Ayako; Iseri, Toshie; Ishizuka, Tomohito; Kakishima, Kei; Kamata, Masatoshi; Miyabe-Nishiwaki, Takako; Nagahama, Shotaro; Naganobu, Kiyokazu; Nishimura, Ryohei; Okano, Shozo; Sano, Tadashi; Yamashita, Kazuto; Yamaya, Yoshiki; Yanagawa, Masashi
• Is Part Of: Veterinary anaesthesia and analgesia. Volume 44:Number 3(2017)
• Page Start: 461
• Page End: 472
• Publication Date: 2017-05
• Subjects: anaesthesia -- dog -- mortality -- preoperative condition -- referral hospital; Veterinary anesthesia -- Periodicals; 636.089
• DOI: 10.1016/j.vaa.2016.08.007
• Languages: English
• ISSNs: 1467-2987

Abstract

Abstract: Objective: To explore the major risk factors linking preoperative characteristics and anaesthesia-related death in dogs in referral hospitals in Japan. Study design: Observational cohort study. Animals: From April 1, 2010 to March 31, 2011, 4323 dogs anaesthetized in 18 referral hospitals in Japan. Methods: Questionnaire forms were collated anonymously. Death occurring within 48 hours after extubation was considered as an anaesthesia-related death. Patient outcome (alive or dead) was set as the outcome variable. Preoperative general physical characteristics, complete blood cell counts, serum biochemical examinations and intraoperative complications were set as explanatory variables. The risk factors for anaesthesia-related death were evaluated using chi-square test or Fisher's exact test, followed by multivariable logistic regression analysis of the data. Significance was set at p < 0.05. Results: Thirteen dogs that died from surgical error or euthanasia were excluded from statistical analysis. The total mortality rate in this study was 0.65% [28/4310 dogs; 95% confidence interval (CI), 0.41–0.89]. Furthermore, 75% (95% CI, 55.1–89.3) of anaesthesia-related deaths occurred in dogs with pre-existing diseases. Most of the deaths occurred postoperatively (23/28; 82.1%; 95% CI, 63.1–93.9). Preoperative serum glucose concentration <77 mg dL –1 (6/46; 13.0%; 95% CI, 4.9–26.3), disturbance of consciousness (6/50; 12.0%; 95% CI, 4.5–24.3), white cell count >15, 200 μL –1 (16/499; 3.4%; 95% CI, 1.9–5.5) and American Society of Anesthesiologists grade III–V (19/1092; 1.7%; 95% CI, 1.1–2.7) were identified as risk factors for anaesthesia-related death. Intraoperative hypoxaemia (8/34; 23.5%; 95% CI, 10.7–41.2) and tachycardia (4/148; 2.7%; 95% CI, 0.7–6.8) were also risk factors for anaesthesia-related death. Conclusions and clinical relevance: The results revealed that certain preoperative characteristics were associated with increased odds of anaesthesia-related death, specifically low serum glucose concentration and disturbances of consciousness. Greater attention to correcting preanaesthetic patient abnormalities may reduce the risk of anaesthesia-related death.