Intraoperative Anesthesia Handoff Does Not Affect Patient Outcomes after Cardiac Surgery: A Single-Center Experience

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2023-06-28 DOI:10.1155/2023/1793257

J. Bloom, D. Paneitz, S. Wolfe, David L. Convissar, T. Sundt, D. D’Alessandro, A. Dalia

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引用次数: 0

Abstract

Background. Intraoperative team turnover is necessary given the duration of many cardiac surgical procedures, despite being an established risk factor for harm. We sought to determine if there was an association between intraoperative anesthesia handoff (AH) and patient morbidity and/or mortality after cardiac surgery. Methods. All adult cardiac surgery procedures from November 2016 through November 2021 were retrospectively interrogated for AH. These results were merged with postoperative patient outcomes data and analyzed for morbidity and mortality. Results. A single AH occurred in 1,087/5,937 (18.3%) procedures, and two or more AHs occurred in 224 (3.8%) procedures. Baseline characteristics show that AH is more frequently associated with higher complexity patients and operations. The primary outcome of operative mortality occurred in 113 (2.4%), 54 (5.0%), and 7 (3.1%) patients in the no AH, single AH, and multiple AH cohorts. After multivariable adjustment, the odds ratio for mortality was 1.15 (95% CI 0.79–1.67 and P = 0.46 ) for a single AH and 0.83 (95% CI 0.36–1.90 and P = 0.66 ) for multiple AH. There were no significant differences in readmission, length of stay, or a composite complication outcome between the cohorts after adjustment. Conclusions. In a large single-center experience, intraoperative anesthesia handoffs were not associated with adverse outcomes after cardiac surgery.

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术中麻醉切换不影响心脏手术后患者的预后:单中心经验

背景考虑到许多心脏外科手术的持续时间，术中团队更替是必要的，尽管这是一个既定的伤害风险因素。我们试图确定术中麻醉切换（AH）与心脏手术后患者发病率和/或死亡率之间是否存在关联。方法。对2016年11月至2021年11月的所有成人心脏外科手术进行了AH回顾性询问。将这些结果与术后患者结果数据合并，并对发病率和死亡率进行分析。后果1087/5937例（18.3%）手术中出现一例AH，224例（3.8%）手术中发生两例或两例以上AH。基线特征显示AH更频繁地与更复杂的患者和手术相关。手术死亡率的主要结果发生在无AH、单一AH和多个AH队列中的113名（2.4%）、54名（5.0%）和7名（3.1%）患者中。多变量校正后，单一AH的死亡率优势比为1.15（95%CI 0.79-1.67，P=0.46），多个AH的死亡率比值比为0.83（95%CI 0.36-1.90，P=0.66）。调整后，两组患者在再次入院、住院时间或复合并发症结果方面没有显著差异。结论。在大型单中心经验中，术中麻醉切换与心脏手术后的不良结果无关。

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 Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.