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Comment & Response
June 5, 2018

Anesthesia Care Handovers and Risk of Adverse Outcomes

Author Affiliations
  • 1Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 2Department of Surgery, University of Western Ontario, London, Ontario, Canada
  • 3Institute of Public Health, Charité—Universitätsmedizin Berlin, Berlin, Germany
JAMA. 2018;319(21):2236. doi:10.1001/jama.2018.4434

To the Editor Dr Jones and colleagues evaluated the issue of adverse outcomes associated with complete transitions in anesthesia care during major inpatient surgery in an observational study.1 Surgeries with handovers were more frequently of urgent or emergent status, longer duration, and different case mix compared with those without handovers. In an effort to control for confounding, the authors used inverse probability weighting and estimated the risk of 30-day death, readmission, or major complication to be 1.23-times higher with handovers. They concluded that handovers should be curtailed; however, important methodological issues should be addressed before hospitals consider restricting handovers or requiring standardized communication with specific checklists.2