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
https://www.rcoa.ac.uk/research/research-projects/national-audit-projects-naps/nap7-report
https://doi.org/10.1111/anae.16208
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 NAP@rcoa.ac.uk for all inquiries or ideas about NAP7. https://www.nationalauditprojects.org.uk/NAP7-Home
Richard Armstrong, HSRC NAP7 Fellow
Jasmeet Soar, NAP7 Clinical Lead
Tim Cook, Director, RCoA National Audit Programmes
Ronelle Mouton, NAP 7 VASGBI representative