In‐hospital Mortality and Associated Complications After Bowel Surgery in Victorian Public Hospitals

Abstract

Notwithstanding some inaccuracies of coding and reporting, the morbidity and mortality for surgery of the large intestine remains high, largely due to the comorbidities of the patients, although certain technical complications such as leakage of an anastomosis after anterior resection are still associated with a significantly increased risk of death. Consideration should be given to the routine use of high-dependency nursing units for these high-risk patients after major colorectal surgery, and support from physicians to reduce morbidity and mortality from associated medical conditions worsened by surgery.

Optimization of Peri-Operative Hdu Care for Elective Colorectal Patients

“…The majority of postoperative complications following colorectal surgery are respiratory and cardiac [4,14]; this has been confirmed in our series. Most of these adverse events occur more than 24 hours following surgery, often when the patients had already been discharged from critical care.…”

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

“…This is comparable with previously published rates in heterogeneous groups which vary widely from 0 to 15 percent but average 5 percent. 11,22,[31][32][33][34][35][36] This also applies for the wound infection rate, which in our study was 7.2 percent in the PEG group and 5.6 percent in the NMP group. A previous review of the wound infection rate in elective open colorectal surgery reported an 11 percent rate.…”

Preoperative Risk Stratification for Mortality and Major Morbidity in Major Colorectal Surgery

“…24 ) Randomness may be inherent in models of biologic systems, as demonstrated by the Victoria Public Hospital study that modeled mortality outcomes in colorectal surgery, and reported a pseudo-R 2 of 0.19. 33 This latter statistic has not been reported in major risk adjustment models, 1,4,[7][8][9] nor have confidence intervals about the risk prediction. By excluding these factors from evaluation of risk models, studies miss an opportunity to better define the strength of association between risk factors and outcomes, and to provide alternate methods for comparing risk assessment models.…”