[Have anesthesia-related mortality and morbidity decreased in the last 30 years? Evaluation based on a review of epidemiologic studies].
The objectives of this lecture are to review the various studies of anaesthetic outcome in order to answer some questions of importance for the clinical practitioner: 1) does anaesthesia contribute to operative mortality and, if yes, to what extent?; 2) has anaesthetic mortality decreased in the last 30 years?; 3) has the risk of major morbidity from anaesthesia been reduced in the past decades?; 4) what are the causes of adverse outcome in anaesthetic practice? The contribution of anaesthesia to perioperative mortality varies from 5 to 15 per cent out of operative deaths according to the data reported in the surveys published during the last decade. The comparison of the data from successive studies in the same country using comparable methodology leads to believe that anaesthetic mortality has decreased in the last 30 years. Similarly, the risk of major morbidity from anaesthesia such as cardiac arrest appears to be reduced when the rate of this complication is compared between two periods. The most preventable causes of adverse anaesthetic outcome are respiratory damaging events. The main causes are inadequate ventilation and/or oxygenation and problems related to tracheal intubation. Most of these cases could have been prevented by a faster detection with the combination of pulse oximetry and capnography.
Desmonts
J M
JM
Département d'Anesthésie et de Réanimation Chirurgicale, CHU Bichat-Claude Bernard, Paris.
D000777:Anesthetics / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome
D000777:Anesthetics
La mortalité et la morbidité liées à l'anesthésie ont-elles diminué dans les 30 dernières années? (Evaluation à partir d'une revue des études épidémiologiques).