Abstract:
BACKGROUND:The significance of intraoperative anesthesia handoffs on patient outcomes are unclear. One aspect differentiating the disparate results is the treatment of confounding factors, such as patient comorbidities and surgery time of day. We performed this study to quantify the significance of confounding variables on composite adverse events during intraoperative anesthesia handoffs. METHODS:In this retrospective study, we analyzed data from the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP). We examined the effects of intraoperative handoffs between anesthesia personnel. A total of 12,111 cases performed examined at two hospitals operated by a single healthcare system that were that included in the ACS NSQIP database performed. The presence of attending and anesthetist or resident handoffs, patient age, sex, body mass index, American Society of Anesthesiologists Physical Status (ASA-PS) classification, case length, surgical case complexity, and evening/weekend start time were measured. RESULTS:A total of 2586 of all cases in the NSQIP dataset experienced a handoff during the case. When analyzed as a single variable, attending handoffs were associated with higher rates of adverse outcomes. However, once confounding variables were added into the analysis, attending handoffs and complete care transitions were no longer statistically significant. CONCLUSIONS:Inclusion of significant covariates is essential to fully understanding the impact provider handoffs have on patient outcomes. Case timing and lengthy case duration are more likely to result in both a handoff and an adverse event. The impact of handoffs on patient outcomes seen in the literature are likely due, in part, to how covariates were addressed.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
O'Reilly-Shah VN,Melanson VG,Sullivan CL,Jabaley CS,Lynde GCdoi
10.1186/s12871-019-0858-8subject
Has Abstractpub_date
2019-10-15 00:00:00pages
182issue
1issn
1471-2253pii
10.1186/s12871-019-0858-8journal_volume
19pub_type
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journal_title:BMC anesthesiology
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pub_type: 杂志文章,多中心研究
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abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC anesthesiology
pub_type: 已发布勘误
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