Evidence map›Paper›PMID 38769493›Full record

SynthesisBMC anesthesiology2024

Mortality and cardiac arrest rates of emergency surgery in developed and developing countries: a systematic review and meta-analysis.

Kaikai Guo, Fengying Xu, Ye Li, Mingxing Ma, Jing Li, Long Wang

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kaikai Guo *Department of pain medicine, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beingjing, China.
Fengying Xu *Department of anesthesiology, No. 971 Hospital of People's Liberation Army Navy, Qingdao, China.
Ye Li *Department of pain medicine, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beingjing, China.
Mingxing MaDepartment of pain medicine, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beingjing, China.
Jing LiDepartment of acupuncture, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Long WangDepartment of pain medicine, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beingjing, China. flynn.xu@163.com.ORCID 0000-0003-4956-9153

Funding

Medical Health Research Project of Qingdao 2021-WJZD239National Natural Science Foundation of China 82271322
6 · The paper itself

Abstract

backgroundThe magnitude of the risk of death and cardiac arrest associated with emergency surgery and anesthesia is not well understood. Our aim was to assess whether the risk of perioperative and anesthesia-related death and cardiac arrest has decreased over the years, and whether the rates of decrease are consistent between developed and developing countries.

methodsA systematic review was performed using electronic databases to identify studies in which patients underwent emergency surgery with rates of perioperative mortality, 30-day postoperative mortality, or perioperative cardiac arrest. Meta-regression and proportional meta-analysis with 95% confidence intervals (CIs) were performed to evaluate global data on the above three indicators over time and according to country Human Development Index (HDI), and to compare these results according to country HDI status (low vs. high HDI) and time period (pre-2000s vs. post-2000s).

results35 studies met the inclusion criteria, representing more than 3.09 million anesthetic administrations to patients undergoing anesthesia for emergency surgery. Meta-regression showed a significant association between the risk of perioperative mortality and time (slope: -0.0421, 95%CI: from - 0.0685 to -0.0157; P = 0.0018). Perioperative mortality decreased over time from 227 per 10,000 (95% CI 134-380) before the 2000s to 46 (16-132) in the 2000-2020 s (p < 0-0001), but not with increasing HDI. 30-day postoperative mortality did not change significantly (346 [95% CI: 303-395] before the 2000s to 292 [95% CI: 201-423] in the 2000s-2020 period, P = 0.36) and did not decrease with increasing HDI status. Perioperative cardiac arrest rates decreased over time, from 113 per 10,000 (95% CI: 31-409) before the 2000s to 31 (14-70) in the 2000-2020 s, and also with increasing HDI (68 [95% CI: 29-160] in the low-HDI group to 21 [95% CI: 6-76] in the high-HDI group, P = 0.012).

conclusionsDespite increasing baseline patient risk, perioperative mortality has decreased significantly over the past decades, but 30-day postoperative mortality has not. A global priority should be to increase long-term survival in both developed and developing countries and to reduce overall perioperative cardiac arrest through evidence-based best practice in developing countries.

Indexed as

Developed CountriesDeveloping CountriesHeart ArrestAnesthesiaEmergenciesHumansPostoperative ComplicationsSurgical Procedures, Operative30-day postoperative mortalityCardiac arrestsEmergency surgeryPerioperative mortality

Identifiers

PMID38769493
PMCPMC11104000

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.