New set of indicators with consensus definition for anaesthesia-related severe morbidity: A scoping review followed by a Delphi study - Centre Eugène Marquis
Article Dans Une Revue Journal of Clinical Anesthesia Année : 2024

New set of indicators with consensus definition for anaesthesia-related severe morbidity: A scoping review followed by a Delphi study

Résumé

Study objective: Monitoring anaesthesia-related severe morbidity constitutes a good opportunity for assessing quality and safety of care in anaesthesia. Several recent studies attempted to describe and define indicators for anaesthesia-related severe morbidity with limitations: no formal experts' consensus process, overlap with surgical complications, no consensual definitions, inapplicability in clinical practice. The aim of this study was to provide a set of indicators for anaesthesia-related severe morbidity based on outcomes and using clinically useful consensual definitions. Design: 1/ scoping review of studies published in 2010-2021 on outcomes of anaesthesia-related severe morbidity with different definitions; 2/ International experts' consensus on indicators for anaesthesia-related severe morbidity with specific definitions using a Delphi process. Main results: After including 142 studies, 68 outcomes for anaesthesia-related severe morbidity were identified and organized in 34 indicators divided into 8 categories (cardiovascular, respiratory, sepsis, renal, neurological, medication error, digestive and others). The indicators were then submitted to the experts. After 2 Delphi rounds, the 26 indicators retained by the experts with their corresponding consensual definition were: acute heart failure, cardiogenic shock, acute respiratory distress syndrome, pulmonary embolism and thrombosis, bronchospasm or laryngospasm, pneumonia, inhalation pneumonitis, pneumothorax, difficult or impossible intubation, atelectasis, self-extubation or accidental extubation, sepsis or septic shock, transient ischemic attack, postoperative confusion or delirium, post-puncture headache, medication error, liver failure, unplanned intensive care unit admission, multiple-organ failure. Conclusions: This study provides a new consensual set of indicators for anaesthesia-related severe morbidity with specific definitions, that could be easily applied in clinical practice as in research.

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Dates et versions

hal-04719981 , version 1 (03-10-2024)
hal-04719981 , version 2 (03-10-2024)

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Marie‐pierre Bonnet, Perrine Guckert, Cécile Boccara, Chafia Daoui, Hélène Beloeil. New set of indicators with consensus definition for anaesthesia-related severe morbidity: A scoping review followed by a Delphi study. Journal of Clinical Anesthesia, 2024, 99, pp.111626. ⟨10.1016/j.jclinane.2024.111626⟩. ⟨hal-04719981v2⟩
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