KEY POINTS

1. Perioperative risk is multifactorial and depends on the interaction of anesthesia-, surgery-, and patient-specific factors.
2. Anesthesia-related (and surgery-related) risk includes morbidity and mortality within 30 days, although shorter periods may be relevant depending on the extent of surgery.
3. Anesthesia and the actions of anesthesiologists may completely or partially cause perioperative morbidity and mortality, but the actions of the anesthesiologist may also decrease or modify risk related to patient disease.
4. In the literature on anesthesia-related risk, the rates of morbidity and mortality depend on the wide variety of definitions found.
5. Studies of anesthesia-related risk have found that postanesthesia respiratory depression is the largest cause of death and coma totally attributable to anesthesia; this finding prompted the development of postanesthesia care units.
6. Research into anesthesia-related cardiac arrests has found them to be attributable to medication administration, airway management, and technical problems of central venous access.
7. Multivariate modeling using logistic regression equations can be used to determine factors associated with increased risk in the cohort and in individuals and has been used to develop risk indices such as the Cardiac Risk Index.
8. Surveys of maternal mortality suggest that the absolute rate of complications by anesthesia type has not decreased but that the increased use of regional anesthesia has led to improvements in outcome.
9. Medication-related and cardiovascular causes of cardiac arrest were the most common causes in the Pediatric Perioperative Cardiac Arrest registry.
10. With increases in outpatient surgery, increased surveillance is required to ensure that appropriate procedures are performed in appropriate locations.