Mortality in Anesthesia: A Systematic Review

Abstract

This systematic review of the Brazilian and worldwide literature aims to evaluate the incidence and causes of perioperative and anesthesia-related mortality. Studies were identified by searching the Medline and Scielo databases, followed by a manual search for relevant articles. Our review includes studies published between 1954 and 2007. Each publication was reviewed to identify author(s), study period, data source, perioperative mortality rates, and anesthesia-related mortality rates. Thirty-three trials were assessed. Brazilian and worldwide studies demonstrated a similar decline in anesthesia-related mortality rates, which amounted to fewer than 1 death per 10,000 anesthetics in the past two decades. Perioperative mortality rates also decreased during this period, with fewer than 20 deaths per 10,000 anesthetics in developed countries. Brazilian studies showed higher perioperative mortality rates, from 19 to 51 deaths per 10,000 anesthetics. The majority of perioperative deaths occurred in neonates, children under one year, elderly patients, males, patients of ASA III physical status or poorer, emergency surgeries, during general anesthesia, and cardiac surgery followed by thoracic, vascular, gastroenterologic, pediatric and orthopedic surgeries. The main causes of anesthesia-related mortality were problems with airway management and cardiocirculatory events related to anesthesia and drug administration. Our systematic review of the literature shows that perioperative mortality rates are higher in Brazil than in developed countries, while anesthesia-related mortality rates are similar in Brazil and in developed countries. Most cases of anesthesia-related mortality are associated with cardiocirculatory and airway events. These data may be useful in developing strategies to prevent anesthesia-related deaths.

A review of paediatric anaesthetic-related mortality, serious adverse events and critical incidents

“…11,47,50 Anaesthetic-related mortality increases by a factor of 50-100 in low-income countries, but may be 1 000-fold higher in certain poor countries. 11,18,19,21,[47][48][49][50][51][52][53][54][55] Bainbridge reported a similar trend in adult patients. 19 Unlike the case in high HDI countries, anaesthetic-related mortality in low HDI countries has not declined.…”

Práticas baseadas em evidências publicadas no Brasil: identificação e reflexão na área da prevenção em saúde humana

“…Two, however, are predominant: Infectology and Hospital Infec on and Child Health and Pediatrics, with eleven studies (represen ng 7.7% of the total each). On the opposite, in some special es, there was only one study: anesthesiology (13) ; asthma (16) ; pain and analgesics (20) ; diagnos c tests and evalua on (53) ; wounds (61) ; gender (32) ; hematology (30) ; immunology (17) ; pulmonology (36) ; and domes c violence (81) . Table 2 displays the methodological approaches of EBP, as well as a classifi ca on of preven on focus types.…”

“…Some tles exemplify the fi rst case: BCG vaccine: effi cacy and indica ons of vaccina on and revaccina on (17) ; Quality of life and food disorders: a systema c review (21) ; Alterna ve and complementary medicine: a metasynthesis (23) ; Childhood poverty and abdominal obesity in adulthood: a systema c review (29) ; The scien fi c study of happiness and health promo on: an integra ve literature review (56) . In the second case: Mortality in anesthesia: a systema c review (13) ; Systema c review and meta-analysis and anbio cs prophylaxis in abdominal hysterectomy (50) ; Surgical posi oning: evidence for nursing care (57) .…”

“…Thus, there were studies that only focused on the prevalence or incidence of health problem events (I) (12)(13)27,32,45,(47)(48)67,81,(83)(84)(85)(86)90,92) ; others to iden fy and/or associate risk factors (II) ( ; and s ll others to correlate interven ons with preven on, prophylaxis or reduc on of events (III) (14)(15)(17)(18)20,23,33,46,(50)(51)(53)(54)(55)58,62,(64)(65)(68)(69)(70)(71)(72)(73)(74)(75)(76)(79)(80)82,89,91,(93)(94) .…”

Anaesthesia Related Death in Prader Willi Syndrome: Appropriate Management and Medical Liability

“…Management of anatomic and functional airway problems (bronchospasm, laryngospasm, muscle rigidity, alveolar collapse) in pediatric and adult patients continues to result in significant morbidity and mortality [16]. Most deaths are due to underlying illness and frailty.…”