Journal article
Association of Anesthesiologist Handovers With Short-term Outcomes for Patients Undergoing Cardiac Surgery
Anesthesia and analgesia, v 131(6), pp 1883-1889
Dec 2020
PMID: 33048912
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Complete handover of anesthesia care to a second anesthesiologist has been demonstrated to be associated with worse short-term adverse outcomes among cardiac surgery patients, but little information from multi-institutional studies is available.
New York's cardiac surgery registry was used to identify patients who underwent cardiac surgery in New York between 2010 and 2016 with and without complete handovers of anesthesia care. A retrospective observational study with inverse probability treatment weighting (IPTW) based on the propensity score was used to adjust for differences in preoperative patient characteristics while comparing differences in the primary outcome (in-hospital/30 day mortality), major complications in the index admission or within 30 days of the index surgery, readmissions within 30 days, and length of stay.
A total of 8.5% of the 103,102 cardiac surgery procedures involved complete handovers. After adjustment, there was a difference between patients with and without handovers in the primary outcome (2.86% vs 2.48%, adjusted risk ratio [ARR] = 1.15 [1.01-1.31]). There was no difference in readmissions within 30 days (13.7% vs 14.4%, ARR = 0.95 [0.90-1.00]), and the differences in complications and length of stay were not clinically meaningful (adjusted differences of <10%).
Cardiac surgery patients in New York who had complete anesthesia handovers experienced higher short-term mortality rates, but there were no meaningful differences in other outcomes. Unnecessary handovers should be carefully monitored.
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Details
- Title
- Association of Anesthesiologist Handovers With Short-term Outcomes for Patients Undergoing Cardiac Surgery
- Creators
- Edward L Hannan - From the Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York, Albany, New York.Zaza Samadashvili - From the Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York, Albany, New York.Thoralf M Sundt, 3rd - Cardiac Surgical Division, Massachusetts General Hospital, Boston, MassachusettsLeonard Girardi - Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York, New York.Joanna Chikwe - Cedars-Sinai Medical CenterAndrew Wechsler - Drexel UniversityDavid H Adams - Mount Sinai HospitalCraig R Smith - NewYork–Presbyterian HospitalJeffrey P Gold - University of Nebraska Medical CenterStephen J Lahey - University of ConnecticutDesmond Jordan - NewYork–Presbyterian Hospital
- Publication Details
- Anesthesia and analgesia, v 131(6), pp 1883-1889
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000589187000044
- Scopus ID
- 2-s2.0-85096052182
- Other Identifier
- 991019168551704721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Anesthesiology