A Quality Improvement Initiative to Reduce Adverse Effects of Transitions of Anesthesia Care on Postoperative Outcomes: A Retrospective Cohort Study
Main findingResult — go to the resultOdds ratio 1.08 95% CI 1.04–1.12Authors' conclusion
Intraoperative handovers are significantly associated with adverse outcomes even after controlling for multiple confounding variables. Use of a structured handover tool during anesthesia care may attenuate the adverse effect.
Study context
- Population
- Adults undergoing noncardiac surgery of at least 1 h, 2016 to 2021
- Participants
- 121,077 cases
- Exposure
- Handover vs Nonhandover
- Handovern = 48,986
- Nonhandovern = 72,091reference
- Outcome
- Composite of:
- Postoperative mortality
- Major postoperative morbidity
Methodological detailsquality improvement initiative, weighted analysis, time series analysis
- Quality improvement initiative
- Weighted analysis
- Time series analysis
Main finding
As reported in the abstract
Odds ratio
1.08
95% CI 1.04–1.12
Events by group
Handover vs Nonhandover
OR 1.08 (95% CI 1.04–1.12)
Observational data: associations, not effects.
Further findings
Use of structured handover tool · after initial intervention
- Marked increase in usage of the structured tool after the initial intervention
Change over time in OR for composite outcome (handover vs nonhandover) · after initial intervention
- Significant decrease in OR over time after the initial intervention (t)
- −3.97
- Slope of OR vs time before intervention
- 0.002 (95% CI, 0.001 to 0.004; P = 0.018)
- Slope of OR vs time after intervention
- −0.011 (95% CI, −0.01 to −0.018; P < 0.001)
Original publication
A Quality Improvement Initiative to Reduce Adverse Effects of Transitions of Anesthesia Care on Postoperative Outcomes: A Retrospective Cohort Study. Anesthesiology. Published 17 November 2023. doi:10.
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