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

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)

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