New Study Shows Surgical Death Rates Not Affected
by Type of Anesthesia Provider
Data reveals no significant differences in surgical mortality rates
when anesthesia is provided by nurse anesthetists
or anesthesiologists working individually or together.
PARK RIDGE, Illinois--Patients are just as safe receiving their anesthesia care from Certified Registered Nurse Anesthetists (CRNAs) or physician anesthesiologists working individually, or from CRNAs and anesthesiologists working in anesthesia care teams, according to a groundbreaking study published in the April 2003 AANA Journal.
The Institute of Medicine estimates that anesthesia care today is nearly 50 times safer than it was 20 years ago, with one anesthesia-related death per 200,000-300,000 cases. Despite this record of improvement, questions have remained about surgical patient safety related to types of anesthesia providers.
The study, titled "Surgical Mortality and Type of Anesthesia Provider," analyzed the effect of different types of anesthesia providers on the death rates of Medicare patients undergoing surgery. Researchers Michael Pine, MD, Kathleen Holt, PhD, and You-Bei Lou, PhD, studied 404,194 cases that took place from 1995-1997 in 22 states.
According to the study, surgical death rates were essentially the same whether anesthesiologists or nurse anesthetists provided the anesthesia individually or worked together in anesthesia care teams. Further, hospitals in which CRNAs were the only anesthesia providers had results similar to hospitals where anesthesiologists were involved in the anesthesia care.
Only cases with clear documentation of type of anesthesia provider were studied, and adjustments were made for differences in case mix, clinical risk factors, hospital characteristics, and geographic location. The types of surgical procedures included carotid endarterectomies, cholecystectomies, herniorrhaphies, mastectomies, hysterectomies, laminectomies, prostatectomies, and knee replacements.
"The results of this study are significant, particularly in this time of anesthesia provider shortages and rising healthcare costs," said Rodney C. Lester, CRNA, PhD, president of the 30,000-member American Association of Nurse Anesthetists (AANA). "It confirms what the AANA has been saying all along: Anesthesia today is safer than it has ever been, regardless of whether the anesthesia provider is a CRNA or an anesthesiologist.
"With the demand for surgical care and other procedures requiring anesthesia growing annually, and an insufficient number of qualified anesthesia providers to satisfy this demand, it is important that the current supply of CRNAs and anesthesiologists be used effectively," said Lester. "It should give patients great comfort to know that they are receiving the same high-quality anesthesia care whether it is provided by a CRNA or an anesthesiologist working individually or in a team."
Nurse anesthetists have been providing anesthesia care in the United States for more than 100 years. Today, CRNAs are the hands-on providers of approximately 65 percent of all U.S. anesthetics, and they are the primary anesthesia caregivers in the military, rural communities, and delivery rooms.
To read the study, visit the AANA Web site at www.aana.com
and click on "Press Releases."