British journal of anaesthesia
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The EuroSCORE associates coronary artery bypass graft (CABG) surgery with higher perioperative risk in the first 3 months after a myocardial infarction (MI). The optimal scheduling of CABG surgery after unstable angina (UA) is unknown. We investigated the preoperative predictors of adverse outcomes in patients undergoing CABG with prior MI or UA and investigated the importance of time interval between the cardiac event and CABG. ⋯ Our hypothesis generating data suggest that the increased risk currently allocated in the EuroSCORE for an interval of 3 months between MI and CABG should be critically re-evaluated. Furthermore, prior MI should not be discounted as a risk factor if it is more than 3 months old.
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Distractions are cited as contributory to healthcare-associated errors in a large proportion of incidents including those involving anaesthetists. The anaesthetist is relatively understudied, despite the closer coupling between action and outcome than in surgery. ⋯ Distracting events involving the anaesthetist are common, but approximately two-thirds of these events have no externally visible effect. Another anaesthetist was the most common recipient of a distracting event initiated by the anaesthetist. Anaesthetists need to address themselves as causes of distractions and the potential impact on patient safety.