相关实验视频
发达国家和发展中国家的术后和麻醉相关死亡率:系统性审查和元分析
Daniel Bainbridge1, Janet Martin, Miguel Arango
1Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, ON, Canada. daniel.bainbridge@lhsc.on.ca
Lancet (London, England)
|September 25, 2012
概括
在过去的50年里,手术和麻醉的死亡风险显著下降,特别是在发达国家. 基于证据的实践对全球进一步减少至关重要,特别是在发展中国家.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 与手术和麻醉相关的全球死亡风险尚未完全理解.
- 术后死亡率的历史趋势和地理差异需要研究.
研究的目的:
- 评估过去五十年中外科及麻醉相关死亡率的下降.
- 为了比较发达国家和发展中国家之间的死亡率下降率.
主要方法:
- 2011年2月发布的87项研究 (超过2140万种麻醉剂) 的系统审查.
- 纳入标准:对>3000名患者的研究,全身麻醉,混合手术群体.
- 超回归分析以确定死亡率及其与人类发展指数 (HDI) 和美国麻醉学会 (ASA) 评分的关系.
主要成果:
- 与麻醉相关的死亡率显著下降,从1970年代前的357/百万下降到1990-2000年代的34/百万.
- 总的外科手术期间死亡率从1970年代前的10603万人/百万下降到1990-2000年代的1176万人/百万.
- 死亡率与HDI有显著的相关性;患者的基线风险 (ASA得分) 随着时间的推移而增加.
结论:
- 在过去的50年里,外科手术期间的死亡率显著下降,发达国家有更大的改善.
- 增加患者基线风险并没有阻碍整体死亡率的降低.
- 优先考虑发展中国家的基于证据的最佳实践对于减少全球外科手术及麻醉相关死亡率至关重要.
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