Perioperative medicine & outcomes
Patient- and Institution-Level Factors Associated With Intraoperative Cardiac Arrest During Major Noncardiac Surgery
Authors' conclusion
Despite the initial reduction in the incidence of IOCA, this study highlights a temporal increase coinciding with the COVID-19 pandemic and an increase in nonelective surgeries.
Study context
- Population
- Adults undergoing noncardiac surgery, 2016 to 2021 National Inpatient Sample
- Outcome
- Frequency, risk factors and outcomes of intraoperative cardiac arrest (IOCA)
Methodological detailsNational Inpatient Sample database, multivariable regression
- National Inpatient Sample database
- Multivariable regression
Main finding
As reported in the abstract
Incidence of IOCA
Noncardiac surgical admissions
0.05%
1294 events
- Incidence increased during the study period, coinciding with more nonelective operations during the COVID-19 pandemic
- 0.05% to 0.06%
Observational data: associations, not effects.
Further findings
Risk factors for intraoperative cardiac arrest (IOCA)
| aOR (95% CI) | ||
|---|---|---|
| Black race | 1.40 (1.20–1.65) | |
| Low-income status | 1.21 (1.02–1.43) | |
| Government nonfederal hospitals | 1.22 (1.08–1.50) | |
| 0.512Adjusted odds ratio (log scale) |
In-hospital mortality after IOCA
- In-hospital mortality rate with IOCA
- 39.3%
- IOCA associated with increased LOS and hospitalization costs
Risk factors for IOCA
- Other key risk factors: advanced age, male sex, high-risk surgical procedures, congestive HF, cardiac arrhythmias, valvular disease
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Patient- and Institution-Level Factors Associated With Intraoperative Cardiac Arrest During Major Noncardiac Surgery. Anesth Analg. Published 7 May 2025. doi:10.
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