| Texto completo | |
| Autor(es): |
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]
Número total de Autores: 8
|
| Afiliação do(s) autor(es): | [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
Número total de Afiliações: 2
|
| Tipo de documento: | Artigo Científico |
| Fonte: | MEDICINE; v. 94, n. 36 SEP 2015. |
| Citações Web of Science: | 8 |
| Resumo | |
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) | |
| Processo FAPESP: | 13/11007-6 - Parada cardíaca intraoperatória e por fator anestésico: revisão sistemática com metanálise proporcional e análise de meta-regressão |
| Beneficiário: | Leandro Gobbo Braz |
| Modalidade de apoio: | Auxílio à Pesquisa - Regular |