Brazilian Journal of Anesthesiology
https://www.bjan-sba.org/journal/rba/article/doi/10.1016/j.bjane.2020.04.014
Brazilian Journal of Anesthesiology
Review Article

Epidemiology of perioperative cardiac arrest and mortality in Brazil: a systematic review

Epidemiologia de parada cardíaca e de mortalidade perioperatória no Brasil: revisão sistemática

Leandro Gobbo Braz, Arthur Caus de Morais, Rafael Sanchez, Daniela de Sá Menezes Porto, Mariana Pacchioni, Williany Dark Silva Serafim, Norma Sueli Pinheiro Módolo, Paulo do Nascimento, Mariana Gobbo Braz, José Reinaldo Cerqueira Braz

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Abstract

Background and objectives
The incidences of perioperative Cardiac Arrest (CA) and mortality in Brazil, a developing country, are higher than in developed countries. The hypothesis of this review was that knowledge of the epidemiology of perioperative CA and mortality in Brazil enables the comparison with developed countries. The systematic review aimed to verify, in studies conducted in Brazil, the epidemiology of perioperative CA and mortality.

Method and results
A search strategy was carried out on different databases (PubMed, EMBASE, SciELO and LILACS) to identify observational studies that reported perioperative CA and/or mortality up to 48 hours postoperatively in Brazil. The primary outcomes were data on epidemiology of perioperative CA and mortality. In 8 Brazilian studies, there was a higher occurrence of perioperative CA and mortality in males, in extremes of age; in patients in worse physical status according to the American Society of Anesthesiologists (ASA); in emergency surgeries; in general anesthesia; and in cardiac, thoracic, vascular, abdominal and neurological surgeries. The patient's illness/condition was the main triggering factor, with sepsis and trauma as the main causes.

Conclusions
The epidemiology of both perioperative CA and mortality events reported in Brazilian studies does not show important differences and, in general, is similar to studies in developed countries. However, sepsis represents one of the major causes of perioperative CA and mortality in Brazilian studies, contrasting with studies in developed countries in which sepsis is a secondary cause.

Keywords

Anesthesia;  Cardiac arrest;  Mortality;  Perioperative period;  Systematic review

Resumo

Justificativa e objetivos
As incidências de Parada Cardíaca (PC) e de mortalidade perioperatória no Brasil, um país em desenvolvimento, são mais elevadas em relação às dos países desenvolvidos. A hipótese desta revisão é que o conhecimento da epidemiologia de PC e de mortalidade perioperatória no Brasil possibilita sua comparação com a dos países desenvolvidos. A revisão sistemática teve como objetivo verificar, em estudos realizados no Brasil, a epidemiologia de PC e de mortalidade perioperatória.

Conteúdo
Realizou-se estratégia de busca em diferentes bases de dados (PubMed, EMBASE, SciELO e LILACS) para a identificação de estudos observacionais que reportaram PC e/ou mortalidade perioperatória até 48 horas pós-operatório no Brasil. Os desfechos primários foram dados de epidemiologia de PC e de mortalidade perioperatória. Em oito estudos nacionais, identificou-se maior ocorrência de PC e de mortalidade perioperatória no sexo masculino, em extremos de idade, em pacientes em pior estado físico segundo a American Society of Anesthesiologists (ASA), em cirurgias de emergência, em anestesia geral, e em cirurgias cardíaca, torácica, vascular, abdominal e neurológica. A doença/condição do paciente foi o principal fator desencadeante, tendo como causas principais sepse e trauma.

Conclusões
Nos estudos nacionais, a epidemiologia dos eventos tanto de PC como de mortalidade perioperatória não apresenta diferenças importantes, e de maneira geral, é semelhante à de estudos de países desenvolvidos. Entretanto, a sepse, nos estudos nacionais, representa uma das principais causas de PC e de mortalidade perioperatória, diferenciando-se dos estudos de países desenvolvidos nos quais a sepse é causa secundária.

Palavras-chave

Anestesia;  Parada cardíaca;  Mortalidade;  Período perioperatório;  Revisão sistemática

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