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J Clin Med. 2019 Dec 1;8(12). pii: E2087. doi: 10.3390/jcm8122087.

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters.

Author information

1
Harvard Medical School, Boston Children's Hospital, Dept. of Anesthesiology, Critical Care and Pain Medicine, 300 Longwood Ave., Boston, MA 02115, USA.
2
University of Colorado School of Medicine, Section Head, Emergency Medicine Colorado Children's Hospital, Aurora, CO 80045, USA.
3
Tauranga OMS, PO. BOX 15557, 3144 Tauranga, New Zealand.
4
Toothbeary Richmond, 358a Richmond Road, East Twickenham TW1 2DU, UK.
5
Summit Anesthesia Services, 1591 Ridge West Dr., Windsor, CO 80550, USA.
6
Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, 91120 Jerusalem, Israel.
7
PO Box 792, Cherrybrook, NSW 2126, Australia.
8
Boston Biostatistical Consulting, North Reading, MA 01864, USA.
9
The Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.

Abstract

Background: The incidence of sedation-related adverse events, inclusive of both adults and children, administered by multiple specialty providers from different countries and venues, using standardized definitions, has never been reported on an international level. We are reporting the outcome data of the adverse event sedation reporting tool as an important step toward a more complete risk assessment of sedation-related morbidity, mortality, and etiology. The analysis of the AE sedation reporting data include descriptive measures to evaluate the characteristics of the provider, the patient, sedations performed, adverse events, interventions, and outcomes. The primary outcome was the rate and nature of adverse events. Between 12/14/2010 and 12/11/2018 there were 7952 sedations, from an estimated total of 164,114 sedations administered, of which 622 were reported as adverse events. The mean age of the entire patient population is 33.0 years (0.02-98.7). The providers represented 39 countries across six continents. Oxygen desaturation (75%-90%) for <60 s is the most prevalent adverse event with a rate of 7.8 per 10,000, followed by airway obstruction at a rate of 5.42 per 10,000. Apnea occurred at a rate of 4.75 per 10,000. Significant predictors of adverse events are ≥ ASA score III (p = 0.0003), procedure time (6:00 pm-12:00 am: p < 0.0001, 12:00-6:00 am: p = 0.0003), and non-hospital location (p < 0.0001). The AE sedation reporting tool has demonstrated that the majority of adverse events in children and adults who receive procedural sedation from multi-specialists internationally required minor interventions and had outcomes of minor risk.

KEYWORDS:

adults; children; pediatrics; safety; sedation

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