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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Anesthesia-Related and Perioperative Cardiac Arrest in Low- and High-Income Countries A Systematic Review With Meta-Regression and Proportional Meta-Analysis

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Author(s):
Koga, Fernando A. [1] ; El Dib, Regina [1] ; Wakasugui, William [1] ; Roca, Cairo T. [1] ; Corrente, Jose E. [2] ; Braz, Mariana G. [1] ; Braz, Jose R. C. [1] ; Braz, Leandro G. [1]
Total Authors: 8
Affiliation:
[1] Univ Estadual Paulista, UNESP, Anesthesia Cardiac Arrest & Mortal Study Commiss, Dept Anesthesiol, Botucatu Med Sch, BR-18618970 Botucatu, SP - Brazil
[2] Univ Estadual Paulista, UNESP, Dept Biostat, Inst Biosci, BR-18618970 Botucatu, SP - Brazil
Total Affiliations: 2
Document type: Journal article
Source: MEDICINE; v. 94, n. 36 SEP 2015.
Web of Science Citations: 8
Abstract

The anesthesia-related cardiac arrest (CA) rate is a quality indicator to improve patient safety in the perioperative period. A systematic review with meta-analysis of the worldwide literature related to anesthesia-related CA rate has not yet been performed.This study aimed to analyze global data on anesthesia-related and perioperative CA rates according to country's Human Development Index (HDI) and by time. In addition, we compared the anesthesia-related and perioperative CA rates in low- and high-income countries in 2 time periods.A systematic review was performed using electronic databases to identify studies in which patients underwent anesthesia with anesthesia-related and/or perioperative CA rates. Meta-regression and proportional meta-analysis were performed with 95% confidence intervals (CIs) to evaluate global data on anesthesia-related and perioperative CA rates according to country's HDI and by time, and to compare the anesthesia-related and perioperative CA rates by country's HDI status (low HDI vs high HDI) and by time period (pre-1990s vs 1990s-2010s), respectively.Fifty-three studies from 21 countries assessing 11.9 million anesthetic administrations were included. Meta-regression showed that anesthesia-related (slope: -3.5729; 95% CI: -6.6306 to -0.5152; P=0.024) and perioperative (slope: -2.4071; 95% CI: -4.0482 to -0.7659; P=0.005) CA rates decreased with increasing HDI, but not with time. Meta-analysis showed per 10,000 anesthetics that anesthesia-related and perioperative CA rates declined in high HDI (2.3 {[}95% CI: 1.2-3.7] before the 1990s to 0.7 {[}95% CI: 0.5-1.0] in the 1990s-2010s, P<0.001; and 8.1 {[}95% CI: 5.1-11.9] before the 1990s to 6.2 {[}95% CI: 5.1-7.4] in the 1990s-2010s, P<0.001, respectively). In low-HDI countries, anesthesia-related CA rates did not alter significantly (9.2 {[}95% CI: 2.0-21.7] before the 1990s to 4.5 {[}95% CI: 2.4-7.2] in the 1990s-2010s, P=0.14), whereas perioperative CA rates increased significantly (16.4 {[}95% CI: 1.5-47.1] before the 1990s to 19.9 {[}95% CI: 10.9-31.7] in the 1990s-2010s, P=0.03).Both anesthesia-related and perioperative CA rates decrease with increasing HDI but not with time. There is a clear and consistent reduction in anesthesia-related and perioperative CA rates in high-HDI countries, but an increase in perioperative CA rates without significant alteration in the anesthesia-related CA rates in low-HDI countries comparing the 2 time periods. (AU)

FAPESP's process: 13/11007-6 - Intraoperative and anesthetic-related cardiac arrest: a systematic review with meta-analysis and meta-regression
Grantee:Leandro Gobbo Braz
Support Opportunities: Regular Research Grants