O’Reilly-Shah VN, et al. - Utilizing data from the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP), researchers quantified the importance of confounding variables on composite adverse events during intraoperative anesthesia handoffs. They evaluated the influences of intraoperative handoffs between anesthesia personnel. A handoff during the case was experienced by 2,586 of all cases in the NSQIP dataset. Higher rates of adverse outcomes were reported in relation to attending handoffs when analyzed as a single variable. However, no statistical significance of attending handoffs and complete care transitions persisted on adding confounding variables into the analysis. In order to acquire a complete understanding of the influence of provider handoffs on patient outcomes, it is important to include significant covariates. A more likelihood of case timing and lengthy case duration causing both a handoff and an adverse event was observed. The literature reports on influence of handoffs on patient outcomes is likely attributable, in part, to how covariates were addressed.