• Marie-Pierre Bonnet, Perrine Guckert, Cécile Boccara, Chafia Daoui, Hélène Beloeil, and SFAR research network.
• Sorbonne University, Department of Anaesthesia and Critical Care Medicine, Armand Trousseau Hospital, DMU DREAM, GRC 29, AP-HP, 75012 Paris, France;; Université Paris Cité, Centre for Epidemiology and Statistics (CRESS), Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPé, INSERM, INRA, 75014 Paris, France. Electronic address: marie-pierre.bonnet@aphp.fr.
• J Clin Anesth. 2024 Sep 17; 99: 111626111626.

Study ObjectiveMonitoring 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.Design1/ 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 ResultsAfter 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.ConclusionsThis 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.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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