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Tytuł pozycji:

The Canadian four-centre study of anaesthetic outcomes: II. Can outcomes be used to assess the quality of anaesthesia care?

Tytuł :
The Canadian four-centre study of anaesthetic outcomes: II. Can outcomes be used to assess the quality of anaesthesia care?
Autorzy :
Cohen MM; Department of Anesthesia, University of Manitoba, Winnipeg, Canada.
Duncan PG
Pope WD
Biehl D
Tweed WA
MacWilliam L
Merchant RN
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Źródło :
Canadian journal of anaesthesia = Journal canadien d'anesthesie [Can J Anaesth] 1992 May; Vol. 39 (5 Pt 1), pp. 430-9.
Typ publikacji :
Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Język :
Imprint Name(s) :
Publication: New York : Springer New York
Original Publication: [Toronto, Ont.] : Canadian Anaesthetists' Society, [c1987-
MeSH Terms :
Outcome Assessment, Health Care*
Quality of Health Care*
Anesthesia/*statistics & numerical data
Anesthesia/adverse effects ; Anesthesia/mortality ; Anesthesia Recovery Period ; Anesthetics/adverse effects ; Canada/epidemiology ; Cause of Death ; Cerebrovascular Disorders/epidemiology ; Critical Care/statistics & numerical data ; Diagnosis-Related Groups ; Female ; Heart Arrest/epidemiology ; Hospital Units/statistics & numerical data ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative/statistics & numerical data ; Myocardial Infarction/epidemiology ; Postoperative Care/statistics & numerical data ; Time Factors
References :
Am J Public Health. 1987 Sep;77(9):1162-6. (PMID: 3113272)
Biometrika. 1967 Jun;54(1):167-79. (PMID: 6049533)
Health Policy. 1988;9(3):331-6. (PMID: 10287865)
Anesthesiology. 1987 May;66(5):670-6. (PMID: 3578880)
Can Anaesth Soc J. 1986 Jan;33(1):22-31. (PMID: 3948043)
Health Serv Res. 1989 Apr;24(1):1-31. (PMID: 2654083)
Anaesthesia. 1956 Jul;11(3):194-220. (PMID: 13340197)
Anaesthesia. 1989 Jun;44(6):504-8. (PMID: 2757158)
JAMA. 1988 Nov 18;260(19):2859-63. (PMID: 3184350)
Can J Anaesth. 1992 May;39(5 Pt 1):420-9. (PMID: 1308755)
Can Anaesth Soc J. 1986 May;33(3 Pt 1):336-44. (PMID: 3719435)
Can J Anaesth. 1987 Jan;34(1):2-8. (PMID: 3829281)
Med Care. 1987 Jun;25(6):489-503. (PMID: 3695658)
Can Anaesth Soc J. 1980 Mar;27(2):159-63. (PMID: 7363145)
Br J Anaesth. 1987 Jul;59(7):834-41. (PMID: 3620263)
Anesthesiology. 1986 Feb;64(2):269-72. (PMID: 3946814)
Stat Med. 1988 Sep;7(9):947-54. (PMID: 3175394)
Anesth Analg. 1991 Aug;73(2):190-8. (PMID: 1854034)
Anesthesiology. 1990 Feb;72(2):252-61. (PMID: 2405738)
Anesthesiology. 1990 Feb;72(2):262-8. (PMID: 2405739)
N Engl J Med. 1990 Mar 8;322(10):707-12. (PMID: 2406600)
Eur J Anaesthesiol. 1984 Mar;1(1):77-84. (PMID: 6536510)
Health Care Financ Rev. 1985 Summer;6(4):103-15. (PMID: 10317668)
Hospitals. 1988 Jul 5;62(13):38-43. (PMID: 3164297)
Substance Nomenclature :
0 (Anesthetics)
Entry Date(s) :
Date Created: 19920501 Date Completed: 19920707 Latest Revision: 20191210
Update Code :
Czasopismo naukowe
Since anaesthesia, unlike medical or surgical specialties, does not constitute treatment, this study sought to determine if methods used to assess medical or surgical outcomes (that is the determination of adverse outcome) are applicable to anaesthesia. Anaesthetists collected information on patient, surgical and anaesthetic factors while data on recovery room and postoperative events were evaluated by research nurses. Data on 27,184 inpatients were collected and the analysis of outcomes determined for the intraoperative, post-anaesthetic care unit and postoperative time periods. Logistic regression was used to control for differences in patient populations across the four hospitals. In addition, a random selection of 115 major events was classified by a panel of anaesthetists into anaesthesia, surgical and patient-disease contributions. Across the three time periods, large variations in minor outcomes were found across the four hospitals; these variations ranged from two- to five-fold after case-mix adjustment (age, physical status, sex, emergency versus elective and length of anaesthesia). The rates of major events and deaths were similar across three hospitals; one hospital had a lower mortality rate (P less than 0.001) but had a higher rate of all major events (P less than 0.0001). Of major events assessed by physician panels, 18.3% had some anaesthetic involvement and no deaths were attributable partially or wholly to anaesthesia. Possible reasons to account for these variations in outcome include compliance in recording events, inadequate case-mix adjustment, differences in interpretation of the variables (despite guidelines) and institutional differences in monitoring, charting and observation protocols. The authors conclude that measuring quality of care in anaesthesia by comparing major outcomes is unsatisfactory since the contribution of anaesthesia to perioperative outcomes is uncertain and that variations may be explained by institutional differences which are beyond the control of the anaesthetist. It is suggested that minor adverse events, particularly those of concern to the patient, should be the next focus for quality improvement in anaesthesia.
Comment in: Can J Anaesth. 1993 Jan;40(1):79-81. (PMID: 8425250)

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