Impact of intraoperative anesthesia handover on major adverse cardiovascular events after thoracic surgery: A propensity-score matched retrospective cohort study

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-02-15 DOI:10.1016/j.jclinane.2025.111778

Xiao-Ling Zhang , Yan Zhou , Mo Li , Jia-Hui Ma , Lin Liu , Dong-Xin Wang

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引用次数: 0

Abstract

Study objective

Handover of anesthesia care is often required in busy clinical settings. Herein, we investigated whether intraoperative anesthesia handover was associated with an increased risk of major adverse cardiovascular events (MACEs) after thoracic surgery.

Design

A retrospective cohort study.

Setting

A tertiary hospital.

Patients

Adult patients who underwent elective thoracic surgery.

Exposures

A complete handover of intraoperative anesthesia care was defined when the outgoing anesthesiologist transferred patient care to the incoming anesthesiologist and no longer returned.

Measurements

Our primary endpoint was a composite of MACEs, including acute myocardial infarction, new-onset congestive heart failure, non-fatal cardiac arrest, and cardiac death, that occurred within 7 days after surgery. The impact of complete anesthesia handover on postoperative MACEs was analyzed using propensity score matching.

Main results

Of 6962 patients (mean age 59.7 years; 57.4 % female) included in the analysis, 2319 (33.3 %) surgeries were conducted with anesthesia handover whereas 4643 (66.7 %) were conducted without. After propensity score matching, 2165 (50.0 %) surgeries were conducted with anesthesia handover whereas the other half were conducted without. Patients with anesthesia handover developed more MACEs when compared with those without (10.4 % [225/2165] vs. 8.4 % [181/2165]; relative risk 1.24, 95 % CI 1.03 to 1.50, P = 0.022). Specifically, myocardial infarction was more common in patients with anesthesia handover than in those without (9.2 % [199/2165] vs. 7.4 % [160/2165]; relative risk 1.24, 95 % CI 1.02 to 1.52, P = 0.032).

Conclusions

For adult patients undergoing thoracic surgery, a complete handover of intraoperative anesthesia care was associated with an increased risk of MACEs after surgery.

查看原文本刊更多论文

术中麻醉交接对胸外科术后主要不良心血管事件的影响：一项倾向评分匹配的回顾性队列研究

研究目的在繁忙的临床环境中，麻醉护理的交接是经常需要的。在此，我们研究了术中麻醉切换是否与胸外科术后主要不良心血管事件（mace）的风险增加有关。设计：回顾性队列研究。三级医院。患者：接受择期胸外科手术的成年患者。术中麻醉护理的完全交接是指即将离职的麻醉师将病人护理转移给即将离职的麻醉师而不再返回。我们的主要终点是术后7天内发生的mes，包括急性心肌梗死、新发充血性心力衰竭、非致命性心脏骤停和心脏性死亡。采用倾向评分匹配分析完全麻醉交接对术后mace的影响。主要结果6962例患者中，平均年龄59.7岁；其中2319例（33.3%）手术进行了麻醉交接，4643例（66.7%）手术未进行麻醉交接。倾向评分匹配后，2165例（50.0%）手术采用麻醉切换，另一半手术不采用麻醉切换。有麻醉切换的患者发生mace的比例高于无麻醉切换的患者（10.4%[225/2165]对8.4% [181/2165]）；相对危险度1.24,95% CI 1.03 ~ 1.50, P = 0.022)。具体而言，麻醉交接患者心肌梗死发生率高于未交接患者（9.2%[199/2165]对7.4% [160/2165]）；相对危险度1.24,95% CI 1.02 ~ 1.52, P = 0.032)。结论对于接受胸外科手术的成年患者，术中麻醉护理的完全交接与术后mace的风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.