(HealthDay News) – Over the last five decades, there has been a decrease in perioperative and anesthesia-related mortality, according to a study published in the Sept 22 issue of The Lancet, a theme issue on surgery.

Daniel Bainbridge, MD, from the University of Western Ontario in London, Canada, and colleagues conducted a systematic review to examine whether the risk of perioperative and anesthesia-related mortality had decreased over the last five decades. They also assessed the differences in the rates of decline in developed and developing countries.

Eighty-seven studies were included, which comprised more than 21.4 million anesthetic administrations for patients undergoing general anesthesia for surgery. The researchers found that, over time, there was a decrease in mortality solely attributable to anesthesia, from 357 per million before the 1970s to 52 per million in the 1970s/1980s to 34 per million in the 1990s/2000s. Over the same time period, total perioperative mortality also decreased, from 10,603 to 4,533 to 1,176 per million, respectively. There was a significant correlation between the risk of perioperative and anesthetic-related mortality and human development index. Over the decades, there was an increase in the baseline risk status of patients who presented for surgery, as indicated by the American Society of Anesthesiologists score.

“Despite an increase in patient baseline risk, perioperative and anesthetic-related mortality rates have steadily declined over the past 50 years,” the authors write. “However, the decline was greatest and most consistent in developed countries, and overall rates of perioperative and anesthetic-related mortality remain two–three times higher in developing countries.”

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