Handover of Intraoperative Anesthesia Care Linked to Increase in Adverse Postoperative Outcomes

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Complete handover of intraoperative anesthesia care is associated with an increased risk of adverse postoperative outcomes among adults undergoing major surgery.

HealthDay News — Complete handover of intraoperative anesthesia care is associated with an increased risk for adverse postoperative outcomes in adults undergoing major surgery, according to a study published in the Journal of the American Medical Association.

In a retrospective cohort study of adult patients undergoing major surgeries, Philip M. Jones, MD, from the University of Western Ontario in London, Canada, and colleagues examined whether complete handover of intraoperative anesthesia care is associated with the likelihood of complications compared with no handover. Data were included for 313,066 patients from April 1, 2009, to March 31, 2015.

The researchers found that 1.9% of patients underwent surgery with complete handover of anesthesia care from 1 physician anesthesiologist to another.

There was an increase in the percentage of patients with a handover of anesthesiology care each year, reaching 2.9% in 2015. The primary outcome (composite of all-cause death, hospital readmission, or major postoperative complications within 30 postoperative days) occurred in 44% and 29% of the complete-handover and no-handover groups, respectively, in the unweighted sample.

After adjustment, complete handovers were correlated with a significantly increased risk of the primary outcome and with all-cause death and major complications but not hospital readmission.

“Complete handover of intraoperative anesthesia care compared with no handover was associated with a higher risk of adverse postoperative outcomes,” the authors write. “These findings may support limiting complete anesthesia handovers.”

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Jones PM, Cherry RA, Allen BN, et al. Association between handover of anesthesia care and adverse postoperative outcomes among patients undergoing major surgery. JAMA. 2018; 319(2):143-153.