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Association between paediatric intraoperative anaesthesia handover and adverse postoperative outcomes

Thomas Kannampallil1, Daphne Lew2, Ethan E Pfeifer3

  • 1Department of Anesthesiology, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA thomas.k@wustl.edu.

BMJ Quality & Safety
|December 8, 2020
PubMed

Insights

Intraoperative anaesthesia handovers in paediatric surgery were not linked to increased adverse postoperative outcomes. This study suggests patient care transitions during anaesthesia may be a safe practice for children.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Patient Safety

Background:

  • Intraoperative handover of patient care is a critical juncture in anaesthesia.
  • Understanding the association between these handovers and patient outcomes is essential for surgical safety.

Purpose of the Study:

  • To investigate if intraoperative anaesthesia handover is associated with adverse postoperative outcomes in paediatric surgical patients.
  • To evaluate the impact of care transitions on patient safety during paediatric surgeries.

Main Methods:

  • Retrospective, population-based cohort study including 78,321 paediatric surgical cases.
  • Utilized inverse probability of exposure weighting with propensity scores for intraoperative handovers.
  • Weighted logistic regression analyzed the association between anaesthesia handovers and postoperative outcomes.

Main Results:

  • No significant difference in the primary outcome (composite of all-cause mortality and major postoperative morbidity within 30 days) between surgeries with and without handovers.
  • Secondary outcomes, including individual components of the primary outcome and 30-day hospital readmission, also showed no significant difference.
  • The odds ratio for the primary outcome was 0.92 (95% CI 0.75 to 1.13, p=0.43).

Conclusions:

  • Intraoperative anaesthesia handovers were not associated with adverse postoperative outcomes in paediatric patients.
  • Findings suggest intraoperative handovers can be considered a care-neutral event.
  • Implications point towards potential strategies for improving patient safety during surgical care transitions.
Abstract

Keywords:
Intraoperative handovershandoffspaediatricpostoperative outcomessafetysurgerytransition of care

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