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. 2018 Dec 4;8(12):e020757. doi: 10.1136/bmjopen-2017-020757

Table 4.

Summary findings table of studies reporting adverse events

POMS categories Study Adverse event description GA RA Summary statistic*/p value
Pulmonary Basques et al 201595 Ventilatory support 58/7253 (0.8%) 13/2589 (0.5%) NR
Pneumonia 261/7253 (3.6%) 108/2589 (4.2%) NR
Bigler et al 198535 Pneumonia 2/20 1/20 NR
Chu et al 201568 Respiratory failure 868/52 043
(1.61%)		 328/52 044 (0.63%) OR 2.71 (95% CI 2.38 to 3.01), p<0.001
Favours RA
Ventilatory support 4008/52 043 (7.70%) 338/52 044 (1.44%) OR 6.08 (95% CI 5.59 to 6.61), p<0.001
Favours RA
Konttinen and Rosenberg 200648 Pneumonia 0/3 2/11 NR
Liu et al 201475 Overall pulmonary 18/172 (25%) 27/145 (25.5%) p=0.934 NS
Hypoxia 19/72 (26.4%) 23/145 (15.9%) p=0.065 NS
Le-Wendling et al 201221 Overall pulmonary 17/235 (6%) 1/73 (1%) OR 2.2 (95% CI 0.7 to 7.2) p=0.0841
Favours RA
Naja et al 2000101 Hypoxia 2/30 (6%) 0/30 (0%) NR
Neuman et al 201220 Overall pulmonary 1030/12 904 (8.1%) 359/5254 (6.8%) p=0.005
Favours RA
Respiratory failure 1040/12 904 (5%) 178/5254 (3.4%) p<0.0001
Favours RA
O’Hara et al 200052 Pneumonia 174/6206 (2.8%) 84/3219 (2.6%) OR 1.21 (95% CI 0.87 to 1.68)
NS
Shih et al 201051 Overall pulmonary 11/167 (6.6%) 3/168 (1.8%) p<0.03
Favours RA
Cardiovascular Basques et al 201595 Myocardial infarction 137/7253 (1.9%) 49/2859 (1.9%) NR
Thromboembolic 138/7253 (1.9%) 25/2589 (1.0%) NR
Bigler et al 198535 Cardiovascular decompensation 1/20 1/20 NR
Pulmonary embolism 1/20 1/20 NR
Chu et al 201568 Myocardial infarction 188/52 043 (0.36%) 169/52 044 (0.32%) OR 1.11 (95% CI 0.9 to 1.37), p=0.31 NS
Fields et al 201569 Thromboembolism 1.64% 0.72% p=0.004
Favours RA
Konttinen and Rosenberg 200648 Myocardial infarction 0/3 1/11 NR
Neuman et al 201639 Myocardial infarction 1/6 0/6 NR
Le-Wendling et al 201221 All cardiovascular complications NR NR OR 1.7 (95% CI 0.4 to 6.3) NS
Seitz et al 201481 Deep vein thrombosis 47/8818 (0.5%) 41/12 155 (0.3%) p=0.03
NS when matched
Pulmonary embolism 100/8818 (1.1%) 93/12 155 (0.8%) p=0.006
NS when matched
Sutcliffe and Parker 199458 Deep vein thrombosis 16/950 (1.7%) 14/383 (3.7%) p<0.05 NS
Pulmonary embolism NR NR NS
Infectious Bigler et al 198535 Wound infection 1/20 0/20 NR
Fields et al 201569 Urinary tract infection 5.76% 8.87% p<0.0001
Favours GA
Rashid et al 201380 Urinary tract infection NR NR NS
Basques et al 201595 Wound infection 94/7253 (1.3%) 39/2589 (1.5%) NS
Renal Basques et al 201595 Acute renal failure 29/7253 (0.4%) 10/2589 (0.4%) NS
Bigler et al 198535 Urinary retention 4/20 5/20 NS
Chu et al 201568 Acute renal failure 78/52 043 (0.15%) 56/52 044 (0.11%) p=0.06 NS
Naja et al 2000101 Acute renal failure 2/30 (6%) 0/30 (0%) NS
Overall complications Gilbert et al 200042 Serious medical complications 55/311 (17.7%) 79/430 (18.4%) OR 0.92 (95% CI 0.61 to 1.4) NS
Gilbert et al 200042
Whiting et al 201596 		Fewer medical complications 109/311 (35.1%) 151/430 (35.1%) OR 1.28 (95% CI 0.90 to 1.82) NS
Surgical complications 15/311 (4.8%) 19/430 (4.4%) OR 1.08 (95% CI 0.65 to 1.21) NS
Major complications NR NR OR 1.43 (95% CI 1.16 to 1.77) NS
Whiting et al 201596
Fields et al 201569 		Minor complications NR NR OR 1.02 (95% CI 0.82 to 1.26) NS
All complications NR NR OR 1.24 (95% CI 1.05 to 1.48) NS
All complications 2357/4813 (48.97%) 830/1815 (45.75%) OR 1.29 (95% CI 1.13 to 1.47), p=0.0002
Favours RA
Hekimoglu Sahin et al 201271 All complications NR NR NS
Ilango et al 201543 All complications NR NR NS
Koval et al 199945 All complications 41/362 (11.3%) 32/280 (11.4%) NS
Liu et al 201475 All complications 17/72 (23.6%) 50/145 (34.5%) p=0.165 NS
Le-Wendling et al 201221 All complications NR NR OR 1.7 (95% CI 0.7 to 4.1) NS
Rashid et al 201380 All complications 22% 19% Log regression model p=0.002
Favours RA
Shih et al 201051 All complications 21/167 (12.6%) 9/168 (5.4%) p<0.02
Favours RA
Chu et al 201568 ITU admissions 5743/52 043 (11.03%) 3205/52 044 (6.16%) OR 1.95 (95% CI 1.87 to 2.05), p<0.001
Favours RA
Specific complications Chu et al 201568 ITU stay >3 days 1206/52 043 (2.32%) 411/52 044 (0.79%) p<0.001
Favours RA
Baumgarten et al 2012107 Pressure ulcers 10/328 (3.0%) 18/313 (5.8%) OR 1.3 (95% CI 1.0 to 1.6) Favours GA
Casati et al 200336 Hypotension requiring crystalloid infusion 12/15 (80%) 7/15 (46%) p=0.05 NS
Maia et al 2014108 Intraoperative hypotension 25/50 80/173 p=0.014
Favours RA
Minville et al 2008109 Intraoperative hypotension 35/42 (83%) 74/109 (68%) NS
Gadsden 2016110 Intraoperative hypotension 569/745 1144/1528 Favours RA
p<0.0001
Messina et al 2013106 Haemodynamic changes first 10 min Mean arterial blood pressure, heart rate, systemic vascular resistance index changes. More disturbance in GA Favours RA
Basques et al 201595 Blood transfusion 2843/7253 (39.2%) 851/2589 (32.9%) Matched OR 1.34 (95% CI 1.22 to 1.49), p<0.001
Favours RA
Fields et al 201569 Blood transfusion 45.49% 39.34% p<0.0001
Favours RA
Minville et al 2008109 Blood transfusion 23% 4% p<0.05
Favours RA
Shih et al 201051 Blood loss Median 250 (0–1600) mL Median 200 (0–1200) mL p=0.01
Favours RA
Chu et al 201568 Stroke 840/52 043 (1.61%) 717/52 044 (1.38%) OR 1.18 (95% CI 1.07 to 1.31), p=0.001
Favours RA
Liu et al 201475 Stroke 5/72 (5.9%) 4/145 (2.8%) p=0.145 NS

*OR, GA vs RA.

GA, general anaesthesia; ITU, intensive treatment unit; NR, not reported; NS, not significant; POMS, postoperative morbidity survey; RA, regional anaesthesia.