Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis
Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis
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DOI：
10.1016/s0140-6736(12)60990-8
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发表时间：
2012-09-22
期刊：
影响因子：
168.9
通讯作者：
Cheng, Davy
中科院分区：
文献类型：
--
作者：
Bainbridge, Daniel;Martin, Janet;Cheng, Davy
背景与手术和麻醉相关的死亡风险的大小还不清楚。我们的目的是评估围手术期和麻醉相关死亡率的风险是否在过去的五十年中有所下降，以及发达国家和发展中国家的下降率是否具有可比性。样本量超过3000，报告了接受全身麻醉的混合手术人群的围手术期死亡率。使用标准表格，两位作者独立确定了纳入的研究，并提取了麻醉相关死亡率、围手术期死亡率、心脏骤停、美国麻醉医师协会（阿萨）身体状况、地理位置、人类发展指数（HDI）和年份的信息。主要结局为麻醉单独死亡率。次要结局为麻醉相关死亡率、围手术期总死亡率和心脏骤停。进行荟萃回归分析，以确定加权事件率的outcomes.Findings 87研究符合纳入标准，其中有超过2140万麻醉管理给接受全身麻醉手术的患者。仅归因于麻醉的死亡率随着时间的推移而下降，从20世纪70年代前的357/100万（95%CI 324-394）降至20世纪70年代至80年代的52/100万（42-64），以及20世纪90年代至21世纪初的34/100万（29-39）（p
Background The magnitude of risk of death related to surgery and anaesthesia is not well understood. We aimed to assess whether the risk of perioperative and anaesthetic-related mortality has decreased over the past five decades and whether rates of decline have been comparable in developed and developing countries.Methods We did a systematic review to identify all studies published up to February, 2011, in any language, with a sample size of over 3000 that reported perioperative mortality across a mixed surgical population who had undergone general anaesthesia. Using standard forms, two authors independently identified studies for inclusion and extracted information on rates of anaesthetic-related mortality, perioperative mortality, cardiac arrest, American Society of Anesthesiologists (ASA) physical status, geographic location, human development index (HDI), and year. The primary outcome was anaesthetic sole mortality. Secondary outcomes were anaesthetic contributory mortality, total perioperative mortality, and cardiac arrest. Meta-regression was done to ascertain weighted event rates for the outcomes.Findings 87 studies met the inclusion criteria, within which there were more than 21.4 million anaesthetic administrations given to patients undergoing general anaesthesia for surgery. Mortality solely attributable to anaesthesia declined over time, from 357 per million (95% CI 324-394) before the 1970s to 52 per million (42-64) in the 1970s-80s, and 34 per million (29-39) in the 1990s-2000s (p