Work

Impact of intraoperative anesthesia handover on major adverse cardiovascular events after thoracic surgery: A propensity-score matched retrospective cohort study

Year: 2025

Type: article

Abstract: STUDY OBJECTIVE: Handover of anesthesia care is often required in busy clinical settings. Herein, we investigated whether intraoperative anesthesia handover was associated with an increased risk of major adverse cardiovascular events (MACEs) after thoracic surgery. DESIGN: A retrospective cohort study. SETTING: A tertiary hospital. PATIENTS: Adult patients who underwent elective thoracic surgery. EXPOSURES: A complete handover of intraoperative anesthesia care was defined when the outgoing anesthesiologist transferred patient care to the incoming anesthesiologist and no longer returned. MEASUREMENTS: Our primary endpoint was a composite of MACEs, including acute myocardial infarction, new-onset congestive heart failure, non-fatal cardiac arrest, and cardiac death, that occurred within 7 days after surgery. The impact of complete anesthesia handover on postoperative MACEs was analyzed using propensity score matching. MAIN RESULTS: Of 6962 patients (mean age 59.7 years; 57.4 % female) included in the analysis, 2319 (33.3 %) surgeries were conducted with anesthesia handover whereas 4643 (66.7 %) were conducted without. After propensity score matching, 2165 (50.0 %) surgeries were conducted with anesthesia handover whereas the other half were conducted without. Patients with anesthesia handover developed more MACEs when compared with those without (10.4 % [225/2165] vs. 8.4 % [181/2165]; relative risk 1.24, 95 % CI 1.03 to 1.50, P = 0.022). Specifically, myocardial infarction was more common in patients with anesthesia handover than in those without (9.2 % [199/2165] vs. 7.4 % [160/2165]; relative risk 1.24, 95 % CI 1.02 to 1.52, P = 0.032). CONCLUSIONS: For adult patients undergoing thoracic surgery, a complete handover of intraoperative anesthesia care was associated with an increased risk of MACEs after surgery.

Source: Journal of Clinical Anesthesia

DOI: 10.1016/j.jclinane.2025.111778

Authors: Xiao-Ling Zhang, Yan Zhou, Mo Li, Jia-Hui Ma, Lin Liu, Dong-Xin Wang

Institution: Peking University First Hospital

Language: English

Topic: Hospital Admissions and Outcomes

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,090