Perioperative and anesthesia-related cardiac arrests in geriatric patients: a systematic review using meta-regression analysis.

• Grant number: 17/10503-0
• Support type: Regular Research Grants - Publications - Scientific article
• Duration: August 01, 2017 - January 31, 2018
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal researcher: Leandro Gobbo Braz
• Grantee: Leandro Gobbo Braz
• Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The worldwide population is aging, and the number of surgeries performed in geriatricpatients is increasing. This systematic review evaluated anesthetic procedures to assess globaldata on perioperative and anesthesia-related cardiac arrest (CA) rates in geriatric surgicalpatients. Available data on perioperative and anesthesia-related CA rates over time and by thecountry's Human Development Index (HDI) were evaluated by meta-regression, and a pooledanalysis of proportions was used to compare perioperative and anesthesia-related CA rates byHDI and time period. The meta-regression showed that perioperative CA rates did not changesignificantly over time or by HDI, whereas anesthesia-related CA rates decreased over time(P=0.04) and in high-HDI (P=0.015). Perioperative and anesthesia-related CA rates per10,000 anesthetic procedures declined in high-HDI, from 38.6 before the 1990s to 7.7 from1990-2017 (P<0.001) and from 9.2 before the 1990s to 1.3 from 1990-2017 (P<0.001),respectively. The perioperative CA rate from 1990-2017 was higher in low-HDI than in high-HDI countries (P<0.001). Hence, a reduction in anesthesia-related CA rates over time wasobserved. Both perioperative and anesthesia-related CA rates only decreased with a high-HDIbetween time periods, and perioperative CA rates during 1990-2017 were 4-fold higher withlow- compared to high-HDI in geriatric patients. (AU)