Anesthesia interventions that alter perioperative mortality: a scoping review

Autor:	Sylvain Boet, Donald R. Miller, David Moher, Nicole Etherington, Daniel I. McIsaac, Nadia Balaa, Karim Mohamed, Isaac Miao, Tatyana Postonogova, Andrew H. Beck, David Nicola, Cassandra T. Mendonca, Manoj M. Lalu, I Carrigan, Benjamin Walker, Sarah Larrigan, José De Wit, Adrienne Stevens, Susan Bragg
Rok vydání:	2018
Předmět:	medicine.medical_specialty MEDLINE Psychological intervention Medicine (miscellaneous) lcsh:Medicine CINAHL Review Cochrane Library law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law Anesthesiology Medicine Humans Anesthesia 030212 general & internal medicine Hospital Mortality Mortality Perioperative Period Randomized Controlled Trials as Topic Perioperative medicine business.industry Research lcsh:R Perioperative business
Zdroj:	Systematic Reviews Systematic Reviews, Vol 7, Iss 1, Pp 1-15 (2018)
ISSN:	2046-4053
Popis:	Background With over 230 million surgical procedures performed annually worldwide, better application of evidence in anesthesia and perioperative medicine may reduce widespread variation in clinical practice and improve patient care. However, a comprehensive summary of the complete available evidence has yet to be conducted. This scoping review aims to map the existing literature investigating perioperative anesthesia interventions and their potential impact on patient mortality, to inform future knowledge translation and ultimately improve perioperative clinical practice. Methods Searches were conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases from inception to March 2015. Study inclusion criteria were adult patients, surgical procedures requiring anesthesia, perioperative intervention conducted/organized by a professional with training in anesthesia, randomized controlled trials (RCTs), and patient mortality as an outcome. Studies were screened for inclusion, and data was extracted in duplicate by pairs of independent reviewers. Data were extracted, tabulated, and reported thematically. Results Among the 10,505 publications identified, 369 RCTs (n = 147,326 patients) met the eligibility criteria. While 15 intervention themes were identified, only 7 themes (39 studies) had a significant impact on mortality: pharmacotherapy (n = 23), nutritional (n = 3), transfusion (n = 4), ventilation (n = 5), glucose control (n = 1), medical device (n = 2), and dialysis (n = 1). Conclusions By mapping intervention themes, this scoping review has identified areas requiring further systematic investigation given their potential value for reducing patient mortality as well as areas where continued investment may not be cost-effective given limited evidence for improving survival. This is a key starting point for future knowledge translation to optimize anesthesia practice.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::65c04543ee5c7ecec44348d22ea51e7a https://pubmed.ncbi.nlm.nih.gov/30497505 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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