Clinical Characteristics of Intraoperative Cardiac Arrest During Cancer Surgery

Purpose Intraoperative cardiac arrest (IOCA) is rare, unpredictable, and may result in a poor outcome. The features of IOCA during cancer surgery and factors related to survival following an IOCA were examined. Methods This was a retrospective study of patients who had cancer surgery under general anesthesia between March 2009 and March 2021 (n = 84,615) to determine the number of patients who had an IOCA. Patients’ clinical information, cause of IOCA, hypoxemia during anesthesia, and the duration of hypotension and CPR were analyzed. Results A total of 22 cases of IOCA occurred during cancer surgery (overall incidence: 2.6 per 10,000 surgeries). Return of spontaneous circulation was achieved in 17 patients, but only 13 survived until discharge. There were statistically significant differences between the deceased and the survival cancer patient groups in; (1) duration of hypoxemia (survival group: 5 minutes, range: 2–18 minutes; deceased group: 60 minutes, range, 22.5–120 minutes; p = 0.019); (2) duration of hypotension (survival group: 35 minutes, range, 15–55 minutes; deceased group 160 minutes, range, 140–185 minutes; p = 0.007); and (3) total duration of CPR (survival group: 3 minutes, range: 1–15 minutes; deceased group: 40 minutes, range: 19–149 minutes; p = 0.005). Conclusion The duration of hypoxemia and hypotension prior to the onset of IOCA, as well as the duration of CPR were associated with the prognosis of IOCA, highlighting the need to reduce multi-organ damage caused by hypoxemia and hypotension during surgery in high-risk patients.