Department of Anesthesiology and Operating Theatre, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Chin Med J (Engl). 2017 Nov 20;130(22):2738-2749. doi: 10.4103/0366-6999.218006.
The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend.
Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016.
A total of 57 studies were selected for further study, including 12 retrospective studies, 35 prospective studies, 3 meta-analyses, 4 reviews, 1 viewpoint, and 2 case reports. Of the total studies, 42 studies were in Chinese while 15 were in English.
The mortality and morbidity associated with geriatric anesthesia in China are not yet completely reported. Some factors have been recognized, while some are yet to be identified and confirmed. Several studies addressed postoperative cognitive dysfunction and postoperative delirium, whereas only a few studies can be found on renal complications. Thus, a nationwide registry is essential for geriatric anesthesia-associated adverse outcomes. The mortality associated with geriatric anesthesia in China should be reported promptly. In the future, the perspective of geriatric anesthesia needs to be expanded into perioperative geriatric medicine to improve the perioperative management strategy based on the postoperative outcome-directed concept transformation.
Anesthesiologists should evaluate the physiological and medical status and focus on the prevention of potential complications in the perioperative setting with the goal to enhance elderly patients' long-term well-being and survival quality.
中国老年患者人群和老年麻醉数量增长迅速。因此，了解中国老年麻醉相关发病率和死亡率对于提高麻醉质量和结果至关重要。本综述的目的是讨论中国老年麻醉相关发病率和死亡率，并指出未来的趋势。
本综述中的文章均根据 2011 年 1 月至 2016 年 12 月源自中国的报告，从万方、中国知网（CNKI）、维普、PubMed 和 Web of Science 数据库中检索。
共选择了 57 项研究进行进一步研究，包括 12 项回顾性研究、35 项前瞻性研究、3 项荟萃分析、4 项综述、1 项观点和 2 项病例报告。在总共的研究中，42 项是中文的，15 项是英文的。
中国老年麻醉相关发病率和死亡率尚未完全报告。一些因素已经得到承认，而有些因素尚未确定和确认。一些研究涉及术后认知功能障碍和术后谵妄，而只有少数研究涉及肾脏并发症。因此，建立一个全国性的登记处对于老年麻醉相关不良结局至关重要。中国老年麻醉相关死亡率应及时报告。未来，老年麻醉的观点需要扩展到围手术期老年医学，以根据术后结果导向的概念转变，改善围手术期管理策略。
麻醉师应在围手术期评估生理和医学状态，并专注于预防潜在并发症，以提高老年患者的长期健康和生存质量。
