The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Postoperative Opioid-induced Respiratory Depression: A Closed Claims Analysis
Open accessAbstract
AbstractAbstract: In a review of 357 acute pain claims from the Anesthesia Closed Claims Project database, 92 cases involved likely opioid-related respiratory depression. The vast majority of these injuries occurred within 24 h of surgery, and 97% were judged as preventable with better monitoring and response. Background: Postoperative opioid-induced respiratory depression (RD) is a significant cause of death and brain damage in the perioperative period. The authors examined anesthesia closed malpractice claims associated with RD to determine whether patterns of injuries could guide preventative strategies. Methods: From the Anesthesia Closed Claims Project database of 9,799 claims, three authors reviewed 357 acute pain claims that occurred between 1990 and 2009 for the likelihood of RD using literature-based criteria. Previously cited patient risk factors for RD, clinical management, nursing assessments, and timing of events were abstracted from claim narratives to identify recurrent patterns. Results: RD was judged as possible, probable, or definite in 92 claims (κ = 0.690) of which 77% resulted in severe brain damage or death. The vast majority of RD events (88%) occurred within 24 h of surgery, and 97% were judged as preventable with better monitoring and response. Contributing and potentially actionable factors included multiple prescribers (33%), concurrent administration of nonopioid sedating medications (34%), and inadequate nursing assessments or response (31%). The time between the last nursing check and the discovery of a patient with RD was within 2 h in 42% and within 15 min in 16% of claims. Somnolence was noted in 62% of patients before the event. Conclusions: This claims review supports a growing consensus that opioid-related adverse events are multifactorial and potentially preventable with improvements in assessment of sedation level, monitoring of oxygenation and ventilation, and early response and intervention, particularly within the first 24 h postoperatively.
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“Moreover, these complications have increasingly resulted in malpractice lawsuits.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [479]
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STOP Questionnaire: A Tool to Screen Patients for Obstructive Sleep Apnea
Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., & Shapiro, C. M. (2008) · Anesthesiology · doi:10.1097/aln.0b013e31816d83e4 · Cited by 2,355
Practice Guidelines for Acute Pain Management in the Perioperative Setting
(2012) · Anesthesiology · doi:10.1097/aln.0b013e31823c1030 · Cited by 1,335
Relation between Malpractice Claims and Adverse Events Due to Negligence
Localio, A. R., Lawthers, A. G., Brennan, T. A., Laird, N. M., Hebert, L. E., Peterson, L. M., Newhouse, J. P., Weiler, P. C., & Hiatt, H. H. (1991) · New England Journal of Medicine · doi:10.1056/nejm199107253250405 · Cited by 717
Effect of Outcome on Physician Judgments of Appropriateness of Care
Caplan, R. A. (1991) · JAMA · doi:10.1001/jama.1991.03460150061024 · Cited by 383
Self-citationThe American Society of Anesthesiologists Closed Claims Project
Cheney, F. W. (1999) · Anesthesiology · doi:10.1097/00000542-199908000-00030 · Cited by 332
Cashman, J. N., & Dolin, S. J. (2004) · British Journal of Anaesthesia · doi:10.1093/bja/aeh180 · Cited by 326
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Extension of the Kappa Coefficient
KRAEMER, H. C. (1980) · Biometrics · doi:10.2307/2529972 · Cited by 237
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Self-citationStandard of Care and Anesthesia Liability
Cheney, F. W. (1989) · JAMA · doi:10.1001/jama.1989.03420110075027 · Cited by 204
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Research works printed but not linked: 2
- 2013, Results of the opioid knowledge assessment from the PA Hospital Engagement Network Adverse Drug Event Collaboration., PA Patient Saf Advis, 10, 19
- 2012, Postoperative monitoring—The Dartmouth experience., APSF Newsl, 27, 1
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Hah, J. M., Bateman, B. T., Ratliff, J., Curtin, C., & Sun, E. (2017) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000002458 · Cited by 728
The Importance of Respiratory Rate Monitoring: From Healthcare to Sport and Exercise
Nicolò, A., Massaroni, C., Schena, E., & Sacchetti, M. (2020) · Sensors · doi:10.3390/s20216396 · Cited by 440
Chung, F., Memtsoudis, S. G., Ramachandran, S. K., Nagappa, M., Opperer, M., Cozowicz, C., Patrawala, S., Lam, D., Kumar, A., Joshi, G. P., et al. (2016) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000001416 · Cited by 360
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350
Beloeil, H., Garot, M., Lebuffe, G., Gerbaud, A., Bila, J., Cuvillon, P., Dubout, E., Oger, S., Nadaud, J., Bécret, A., et al. (2021) · Anesthesiology · doi:10.1097/aln.0000000000003725 · Cited by 334
Metadata
- Authors
- Lee, L. A., Caplan, R. A., Stephens, L. S., Posner, K. L., Terman, G. W., Voepel-Lewis, T., & Domino, K. B.
- Affiliations
- Virginia Mason Medical Center (US)
- From the Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee (L.A.L.); Department of Anesthesiology, Virginia Mason Hospital and Seattle Medical Center, Seattle, Washington (R.A.C.); Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington (L.S.S., K.L.P., G.W.T., K.B.D.); and Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan (T.V.-L.).
- Corresponding author
- Lee, Lorri A.
- Venue
- Anesthesiology
- Published
- 2015-03
- Volume
- 122
- Issue
- 3
- Pages
- 659-665
- ISSN
- 0003-3022 (ISSN-L)
- OpenAlex
- W1991187412
- Semantic Scholar
- 0811af5773d2b84f6cd0f08b396f84c91095d106
- Cited by
- 451
- References
- 22
- Citations by year
- 2026: 22 · 2025: 34 · 2024: 37 · 2023: 27 · 2022: 36 · 2021: 59 · 2020: 53 · 2019: 45 · 2018: 48 · 2017: 48 · 2016: 35 · 2015: 6
- FWCI
- 78.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- University of Texas System
- Anesthesia Quality Institute
- Society of Anesthesia and Sleep Medicine
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- opioid-induced respiratory depression, postoperative complications, sedation monitoring, nursing assessment, sleepiness, preventable adverse events
- MeSH terms
- Adult, Aged, Analgesics, Opioid, Anesthesia, Female, Humans, Insurance Claim Review, Male, Middle Aged, Postoperative Complications, Respiratory Insufficiency, Databases, Factual
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