Quality of Reporting of Regional Anesthesia Outcomes in the Literature

Authors

  • Alexander Stojadinovic MD,

    1. Army Regional Anesthesia & Pain Management Initiative, Anesthesia & Operative Service, Walter Reed Army Medical Center;
    2. Department of Surgery, Walter Reed Army Medical Center, Washington, DC, USA
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  • Sean M. Shockey MD,

    1. Army Regional Anesthesia & Pain Management Initiative, Anesthesia & Operative Service, Walter Reed Army Medical Center;
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  • Scott M. Croll MD,

    1. Army Regional Anesthesia & Pain Management Initiative, Anesthesia & Operative Service, Walter Reed Army Medical Center;
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  • Chester C. Buckenmaier III MD

    Corresponding author
    1. Army Regional Anesthesia & Pain Management Initiative, Anesthesia & Operative Service, Walter Reed Army Medical Center;
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  • The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.

  • Dr Stojadinovic and Dr Shockey share first authorship.

  • Financial support: 1. John P. Murtha Neuroscience & Pain Institute; 2. Departmental.

Chester C. Buckenmaier III, MD, Walter Reed Army Medical Center, Building 2, Ward 44, Room 4418, 6900 Georgia Avenue, NW, Washington, DC 20307-5001, USA. Tel: 202-782-2947; Fax: 202-782-5066; E-mail: chester.buckenmaier@amedd.army.mil.

ABSTRACT

Objective.  Consistent and reliable standards for reporting of regional anesthetic adverse events are lacking. The quality of reporting of regional anesthetic morbidity has not been assessed critically.

Aim.  To evaluate quality of regional anesthesia outcomes reporting.

Methods.  Published retrospective or prospective observational cohort or randomized controlled trials in peer-reviewed journals were reviewed, and judged according to seven criteria related to quality of reporting of regional anesthesia complications: method of accrual, duration of data collection, definition of complication, morbidity and mortality rates, grade of complication severity, exclusion criteria, and study follow up. Differences in reporting outcomes according to study design, sample size and time period were compared.

Results.  Ninety-one articles published from 1996–2006 involving 8,833 patients were analyzed. The majority of studies (75%) met ≤4 reporting criteria. Recently published, prospective studies with >200 patients were associated with significantly higher-quality reporting (P < 0.05). Fewer than 50% of studies reported at least one recognized, accepted complication with defined criteria or indicated duration of follow up. Reporting compliance was worse (29%) for reporting of actual morbidity rates, and complications leading to death. Complication severity grading related to regional anesthesia was reported in 2% of studies.

Conclusion.  Consistent and comparative regional anesthesia outcome data are lacking in peer-reviewed journals. A graded regional anesthetic morbidity and mortality system according to the intensity of therapy required for the treatment of the defined complication is proposed, along with a structured format for the reporting of regional anesthesia complications according to defined reporting standards.

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