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Perioperative morbidity and mortality in the first year of life: a systematic review (1997-2012)
Dora Catré1, Maria Francelina Lopes2, Joaquim Silva Viana3
1Centro Hospitalar Tondela-Viseu, Viseu, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.
Insights
General anesthesia and surgery in infants carry significant risks. Neonates face the highest incidence of anesthetic-related morbidity and mortality, underscoring the need for specialized pediatric care.
Area of Science:
- Pediatric Anesthesiology
- Surgical Outcomes Research
- Neonatal Critical Care
Background:
- The first year of life, particularly the neonatal period, is recognized as a high-risk phase for anesthetic complications.
- Limited research specifically addresses anesthetic morbidity and mortality in these vulnerable pediatric subpopulations.
Purpose of the Study:
- To systematically review the scientific literature over the past 15 years.
- To analyze the epidemiology of morbidity and mortality associated with general anesthesia and surgery in infants.
- To focus on the neonatal (0-30 days) and infant (1-12 months) age groups.
Main Methods:
- Conducted a systematic literature search of Medline/PubMed databases.
- Evaluated outcomes including early mortality (<1 year, 0-30 days, 1-12 months).
- Assessed the prevalence of cardiac arrest and critical perioperative adverse events.
Main Results:
- The literature reveals considerable variability in mortality and morbidity rates.
- Methodological heterogeneity and a lack of specific studies were noted.
- Anesthesia in children under one year shows higher morbidity and mortality frequencies.
Conclusions:
- Infants undergoing anesthesia exhibit increased rates of morbidity and mortality.
- Neonates demonstrate the highest incidence peaks for anesthetic-related adverse events.
- Further targeted research is needed to address anesthetic risks in this population.
Background And Objectives:
Although many recognize that the first year of life and specifically the neonatal period are associated with increased risk of anesthetic morbidity and mortality, there are no studies directed to these pediatric subpopulations. This systematic review of the scientific literature including the last 15 years aimed to analyze the epidemiology of morbidity and mortality associated with general anesthesia and surgery in the first year of life and particularly in the neonatal (first month) period.
Content:
The review was conducted by searching publications in Medline/PubMed databases, and the following outcomes were evaluated: early mortality in the first year of life (<1 year) and in subgroups of different vulnerability in this age group (0-30 days and 1-12 months) and the prevalence of cardiac arrest and perioperative critical/adverse events of various types in the same subgroups.
Conclusions:
The current literature indicates great variability in mortality and morbidity in the age group under consideration and in its subgroups. However, despite the obvious methodological heterogeneity and absence of specific studies, epidemiological profiles of morbidity and mortality related to anesthesia in children in the first year of life show higher frequency of morbidity and mortality in this age group, with the highest peaks of incidence in the neonates' anesthesia.
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