NAP7 - Perioperative Cardiac Arrest

VASGBI was a stakeholder in NAP7 that studied peri-operative cardiac arrest in the UK over a 12-month period, from 16 June 2021 to 15 June 2022.

The results of the vascular surgery cohort were published as a chapter and also as a paper in Anaesthesia

Anaesthesia for vascular surgery accounted for 2% of UK anaesthetic caseload and included 69 (8%) reported peri-operative cardiac arrests, giving an estimated incidence of 1 in 670 vascular anaesthetics (95%CI 1 in 520–830). The high-risk nature of the vascular population is reflected by the proportion of patients who were ASA physical status 4 (30, 43%) or 5 (19, 28%); age of patients (80% aged > 65 y); and that most cardiac arrests (57, 83%) occurred during non-elective surgery. The most common vascular surgical procedures among patients who had a cardiac arrest were aortic surgery (38, 55%); lower-limb revascularisation (13, 19%) and lower-limb amputation (8, 12%). Among patients having vascular surgery and who had a cardiac arrest, 28 (41%) presented with a ruptured abdominal aortic aneurysm. There were 48 (70%) patients who had died at the time of reporting to NAP7 and 11 (16%) were still in hospital, signifying poorer outcomes compared with the non-vascular surgical cohort. The most common cause of cardiac arrest was major haemorrhage (39, 57%), but multiple other causes reflected the critical illness of the patients and the complexity of surgery. This is the first analysis of the incidence, management and outcomes of peri-operative cardiac arrest during vascular anaesthesia in the UK.

Please contact the NAP7 team on for all inquiries or ideas about NAP7.

Richard Armstrong, HSRC NAP7 Fellow
Jasmeet Soar, NAP7 Clinical Lead
Tim Cook, Director, RCoA National Audit Programmes
Ronelle Mouton, NAP 7 VASGBI representative