Anesthesia interventions that alter perioperative mortality: a scoping review

Area of Science:

• Anesthesiology and Perioperative Medicine
• Clinical Practice Improvement
• Evidence-Based Medicine

Background:

• Over 230 million surgeries occur globally each year, highlighting the need to reduce practice variations in anesthesia and perioperative care.
• A comprehensive summary of existing evidence on perioperative anesthesia interventions and their impact on patient mortality is lacking.
• This study addresses the need for a structured overview to inform clinical practice and improve patient outcomes.

Purpose of the Study:

• To conduct a scoping review of existing literature on perioperative anesthesia interventions.
• To identify interventions with a potential impact on patient mortality.
• To inform future knowledge translation and optimize perioperative clinical practice.

Main Methods:

• Searched major databases (MEDLINE, EMBASE, CINAHL, Cochrane Library) from inception to March 2015.
• Included randomized controlled trials (RCTs) involving adult surgical patients receiving anesthesia and reporting patient mortality.
• Extracted and thematically reported data from eligible studies.

Main Results:

• 369 RCTs (147,326 patients) met the inclusion criteria from over 10,505 initial publications.
• Identified 15 intervention themes, with 7 demonstrating a significant impact on mortality.
• Significant mortality impacts were observed in pharmacotherapy (23 studies), nutrition (3 studies), transfusion (4 studies), ventilation (5 studies), glucose control (1 study), medical devices (2 studies), and dialysis (1 study).

Conclusions:

• This scoping review maps intervention themes, identifying areas for further investigation to reduce patient mortality.
• Highlights specific intervention areas (e.g., pharmacotherapy, ventilation) with demonstrated impact on survival.
• Provides a foundation for knowledge translation to optimize anesthesia practice and improve patient outcomes.