This study was aimed to investigate the risk events during the peri-anesthesia period in primary hospitals in Jiangsu province, in order to help anesthetists discern the underlying crisis and guarantee the safety of surgical patients in primary hospitals.

This investigation employed multi-stage stratified cluster random sampling method, and 100 cases of medical crises were selected from 64 primary hospitals in 2018~2020. The investigators collected information by reviewing medical records and interviewing with attending physicians. Demographic characteristics, preoperative evaluations, and anesthesia regimes of these cases were analyzed in detail.

Male patients suffered various risks at a median age of 66 [20] years, with general, orthopedic, and thoracic surgeries being the main surgical types. Female patients suffered diverse risks at a median age of 56 [33] years, with obstetric, general, and orthopedic surgeries being the main surgical types, followed by gynecologic and thoracic surgeries. The patients suffered much more risk events in the 60~69, 70~79, and 50~59 age groups, and they were most likely complicated with hypertension (51.4%), diabetes (13.9%), cerebral infarction (11.1%), and coronary disease (5.6%). Assessment of cardiac function was of great clinical significance, including the heart rate and rhythm assessed by electrocardiogram, and the ejecting fraction and pulmonary arterial pressure assessed by echocardiography. These patients showed physical statuses of American Society of Anesthesiologists (ASA)-Ⅱ (45.2%), ASA-Ⅲ (30.1%), ASA-Ⅰ (14.0%), and ASA-Ⅳ (10.8%), respectively. Eighty-seven patients received general anesthesia, eleven received neuraxial anesthesia, and two received peripheral nerve block. Supply-demand ratio was 88.6% for invasive arterial blood pressure monitoring and 107.1% for central vein catheterization.

Clinical anesthetists should sufficiently get familiar with the specific age and surgical types of risky patients, reasonably assess the cardiac function and accompanying diseases, rationally choose anesthetic techniques and agents, and actively establish invasive monitoring, to guarantee life safety for surgical patients. Undoubtedly, the improvement of anesthesia quality would greatly guarantee the safety of surgical patients in primary hospitals.