Key result
Agreement among three veterinary anesthesiologists in classifying 432 peri-anesthetic deaths in dogs and cats as anesthesia-related was weak, with an overall agreement of 29.6% (Light's Kappa 0.17).
Why the study?
Determining the cause of death during small animal anesthesia poses challenges due to varying definitions, limited information, and differences in evaluators' interpretations.
Observational (n=432)
Yes
Effect estimate: Light's Kappa 0.17
p-value: p=0.00026
There is weak inter-observer agreement among veterinary anesthesiologists in classifying anesthetic-related deaths in dogs and cats, highlighting the need for standardized definitions.
Weak agreement cautions against unstandardized mortality classifications in veterinary anesthesia; leaves open the need for consensus definitions in future studies.
Determining the cause of death in studies assessing mortality during small animal anesthesia poses challenges due to varying definitions of anesthetic death, limited information, and differences in evaluators' interpretations. This study aims to establish the interobserver agreement in classifying the cause of death in anesthetized animals. The observational, retrospective, multicenter study analyzed 432 deaths (83 cats and 349 dogs). Data were collected from a database of 55,022 anesthetized dogs and 14,962 anesthetized cats, created to investigate anesthetic-related mortality in these species. Three highly qualified veterinary anesthesiologists independently assessed whether the deaths were related to anesthesia, using their professional judgment. Data were collected from questionnaires that included the animal's signalment, reason for anesthesia, ASA status, drugs, anesthetic procedures, and comments from the submitting veterinarian. Light's Kappa and the intraclass correlation coefficient (ICC) measured interrater agreement among the three evaluators, while Cohen's Kappa assessed interrater reliability between pairs of observers (p < 0.05). Evaluators A, B, and C classified 296/432 (68.5%), 264/432 (61.1%), and 54/432 (12.5%) of the cases as anesthesia-related deaths, respectively. Agreement among the three evaluators was 128/432 (29.6%) [Light's Kappa: 0.17, p = 0.00026; ICC: 0.06, p-value = 0.0167]. The three evaluators agreed on classifying a death as anesthetic-related in 14.1% of cases (50 out of 354 cases where at least one evaluator classified the death as anesthetic-related). Similarly, for non-anesthetic-related deaths, the three evaluators reached an agreement in 20.4% of cases (78 out of 382 cases where at least one evaluator classified the death as non-anesthetic-related). Overall, agreement between two out of three evaluators was 304/432 (70.4%). Evaluators A and B had a 65.7% agreement [Cohen's Kappa: 0.25, p < 0.00001], A and C had a 46.6% agreement [Cohen's Kappa: 0.10, p < 0.00001], and B and C had a 50.9% agreement [Cohen's Kappa: 0.16, p < 0.00001]. In conclusion, the evaluators' agreement was weak, highlighting the need for a consensus on defining anesthetic mortality in dogs and cats.
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Hernández-Magaña et al. (2025) conducted an observational in Peri-anesthetic mortality in cats and dogs (n=432). Veterinary anesthesiologist evaluation of cause of death was evaluated on Inter-observer agreement among three evaluators in classifying deaths as anesthesia-related (Light's Kappa 0.17, p=0.00026). Agreement among three veterinary anesthesiologists in classifying 432 peri-anesthetic deaths in dogs and cats as anesthesia-related was weak, with an overall agreement of 29.6% (Light's Kappa 0.17).
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