Anaesthesia Cardiac Arrest and Mortality Study Commission, Department of Surgical Specialties and Anaesthesiology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, SP, Brazil.
Anaesthesia Cardiac Arrest and Mortality Study Commission, Department of Surgical Specialties and Anaesthesiology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, SP, Brazil.
J Clin Anesth. 2021 Sep;72:110273. doi: 10.1016/j.jclinane.2021.110273. Epub 2021 May 3.
Studies have demonstrated gaps between developed and developing countries in the quality of surgical and anaesthesia care. The aim of this review was to provide a critical overview of documented outcomes from the 2010s of anaesthesia-related cardiac arrest events in countries with largely differing Human Development Indexes (HDIs). The HDI ranges from 0 to 1, representing the lowest and highest levels of development, respectively. Most related studies conducted between 2011 and 2020 showed low rates (from 0 to 215 per million anaesthetics) of anaesthesia-related mortality up to the 30th postoperative day in very high-HDI countries (HDI ≥ 0.800) and higher rates (from 0 to 915.4 per million anaesthetics) in high-HDI countries (HDI: 0.700-0.799). Low-HDI countries (HDI < 0.550) showed higher anaesthesia-related mortality rates, which were greater than 1500 per million anaesthetics. The anaesthesia-related mortality rates per quartile demonstrated a gap in the anaesthesia-related safety between very high- and high-HDI countries, and especially between very high- and low-HDI countries. Anaesthesia-related cardiac arrest showed similarly high survival proportions in very high-HDI countries (45.9% to 100%) and high-HDI countries (62.9% to 100%), while in a low-HDI country, the anaesthesia-related cardiac arrest survival was lower (22.2%). Our review demonstrates large gaps among countries with largely differing HDIs regarding anaesthesia-related cardiac arrest outcomes in the last decade. This finding highlights the need to improve patient safety care in low-HDI countries. Anaesthesia patient safety has improved in high-HDI countries, but there is still a persistent gap in the health care systems of these countries and those of very high-HDI countries. Our review also found a consistent improvement in anaesthesia patient safety in very high-HDI countries.
研究表明，在外科和麻醉护理质量方面，发达国家和发展中国家之间存在差距。本综述的目的是批判性地概述 2010 年代在人类发展指数（HDI）差异较大的国家中与麻醉相关的心脏骤停事件的记录结果。HDI 的范围从 0 到 1，分别代表最低和最高的发展水平。大多数在 2011 年至 2020 年之间进行的相关研究表明，在非常高 HDI 国家（HDI≥0.800），术后第 30 天内，与麻醉相关的死亡率较低（每百万麻醉 0 至 215 例），在高 HDI 国家（HDI：0.700-0.799）中死亡率较高（每百万麻醉 0 至 915.4 例）。低 HDI 国家（HDI<0.550）的与麻醉相关的死亡率更高，超过每百万麻醉 1500 例。按四分位距划分的与麻醉相关的死亡率显示，非常高和高 HDI 国家之间以及特别是非常高和低 HDI 国家之间在与麻醉相关的安全性方面存在差距。在非常高 HDI 国家（45.9%至 100%）和高 HDI 国家（62.9%至 100%）中，与麻醉相关的心脏骤停的存活率比例相似较高，而在低 HDI 国家中，与麻醉相关的心脏骤停存活率较低（22.2%）。我们的综述表明，在过去十年中，在与麻醉相关的心脏骤停结果方面，具有不同 HDI 的国家之间存在很大差距。这一发现强调了需要改善低 HDI 国家的患者安全护理。高 HDI 国家的麻醉患者安全状况有所改善，但这些国家的医疗保健系统与非常高 HDI 国家的医疗保健系统之间仍存在持续差距。我们的综述还发现，在非常高 HDI 国家中，麻醉患者安全状况持续改善。
