In the Literature

Summary of "Association Between Intraoperative Anesthesia Handover and Patient Morbidity and Mortality: a Systematic Review and Meta-Analysis"

Summary published October 5, 2026

Summary by Jonathan B. Cohen MD, MS, CPPS, FASA

Anesthesia & Analgesia | August 2026

Yao YT, Samost-Williams A, Allafy L, More A, Lin WW, Li YF, Chao M, Baranov A, Anderson VL, Chamoun R, Tore M, Tharavath V, Nacif LO, Dhakal BR, Khudirat M, Akinwunmi S, Luo YT, Tolan J, Uzair S, Turan A. Association Between Intraoperative Anesthesia Handover and Patient Morbidity and Mortality: a Systematic Review and Meta-Analysis. Anesth Analg. 2026 Aug 24. doi: 10.1213/ANE.0000000000008269. Epub ahead of print. PMID: 42644832.

doi: https://doi.org/10.1213/ane.0000000000008269

  • Intraoperative anesthesia handovers (IAH) are common in longer and complex cases and are often used to accommodate work-hour regulations and shift-based staffing schedules.
  • Transfer of patient care responsibilities between anesthesia professionals creates a potential patient safety risk resulting from communication failures occurring during IAH, but relatively few studies have sought to quantify this risk.
  • In this systematic review and meta-analysis, the authors reviewed 12 retrospective cohort studies and 1 multicenter randomized controlled trial that compared patients with and without an IAH and reported postoperative mortality or morbidity.
  • Studies were excluded if they focused on breaks rather than permanent handover of the case, looked at handover from the OR to post-op care locations (ICU/PACU) rather than handover of patients during the anesthetic, or were based on simulation, questionnaires, or surveys.
  • Seven studies (including nearly 500,000 patients) reported adjusted odds ratios and were included in the meta-analysis of composite mortality and morbidity. Of these, 4 reported positive associations between IAH and composite morbidity and mortality and 3 reported neutral findings.
  • Overall, the authors’ exploratory meta-analysis of these 7 studies demonstrated no statistically significant association between IAH and the composite incidence of postoperative mortality and morbidity.
  • Four additional studies examined postoperative mortality alone, including in-hospital, 30-day, and combined mortality and found a trend between IAH and increased postoperative mortality observed. Two studies evaluated postoperative morbidity alone and found mixed results.
  • The authors concluded that IAH may not inherently increase postoperative risks and noted that the association between IAH and postoperative outcomes appeared to vary by surgical population, suggesting the risk of IAH depends on surgical complexity and the baseline risk of the surgical populations studied.
  • Future research should seek to identify specific surgical and patient factors that may increase the risk of IAH, as well as specific interventions aimed at mitigating this risk.