Bibliometric analysis of international, English-language publication activity in anesthesiology, pain medicine, and intensive and emergency medicine over a 10-year interval

BACKGROUND: The present study aimed to clarify how English-language publication activity in anesthesiology, intensive care medicine, and pain medicine has evolved in publishing countries over a 10-year period, considering not only publication volume but also scientific impact and shifting research methodologies. METHODS: A bibliometric analysis of 20,741 publications indexed in PubMed for the time periods 2008/09 and 2018/19 was performed across 30 journals. Journals were selected based on their impact factor (IF) in 2019. Publications were analyzed for total number, cumulative impact factors (CIF) - representing the sum of individual journal impact factors multiplied by the number of publications in each journal - study type, country of origin, and country output per million inhabitants. RESULTS: From 2008/09 to 2018/19, total publication volume declined by 6.9% from 10,740 to 10,001, while CIF increased by 25.4% from 42,441.2 to 53,219.1. Clinical (Observational) studies were most frequent; meta-analyses and registry studies rose markedly (216.1% and 125.3%, respectively), while experimental studies and randomized controlled trials (RCTs) declined (-51.9% and -29.7%, respectively). The United States led in both publication count (2008/09: 3,267; 2018/19: 4,250) and CIF (2008/09: 14,256.4; 2018/19: 24,421.9). When adjusted to population, smaller countries including Denmark (2008/09: 31.1; 2018/19: 80.7), Switzerland (2008/09: 23.6; 2018/19: 42.1), and the Netherlands (2008/2009: 26.3; 2018/2019: 34.9) ranked highest. Germany - the only leading country showing declining publication output at 7.0% - demonstrated a concerning trend, while China (+83.6%) and Canada (+69.4%) showed exceptional growth. CONCLUSIONS: This study identifies a decline in publication volume alongside increased citation activity in high impact anesthesiology and intensive care medicine journals, largely driven by the dominance of clinical studies and a growing prevalence of meta-analyses and registry studies, suggesting a shift in research priorities. Reduced publication numbers likely result from increasing journal selectivity and redistribution of research output toward open-access and non-specialty journals. The country ranking is dominated by the USA and other English-speaking nations, which can be attributed to the English-language literature analyzed. However, smaller nations like Denmark and Switzerland lead in population-based ranking, revealing critical insights into research infrastructure and institutional support.