Postoperative mortality after inpatient surgery: Incidence and risk factors

Abstract

Purpose:This study determined the incidence of and identified risk factors for 48 hour (h) and 30 day (d) postoperative mortality after inpatient operations.Methods:A retrospective cohort study was conducted using Anesthesiology’s Quality Indicator database as the main data source. The database was queried for data related to the surgical procedure, anesthetic care, perioperative adverse events, and birth/death/operation dates. The 48 h and 30 d cumulative incidence of postoperative mortality was calculated and data were analyzed using Chi-square or Fisher’s exact test and generalized estimating equations.Results:The 48 h and 30 d incidence of postoperative mortality was 0.57% and 2.1%, respectively. Higher American Society of Anesthesiologists physical status scores, extremes of age, emergencies, perioperative adverse events and postoperative Intensive Care Unit admission were identified as risk factors. The use of monitored anesthesia care or general anesthesia versus regional or combined anesthesia was a risk factor for 30 d postoperative mortality only. Time under anesthesia care, perioperative hypothermia, trauma, deliberate hypotension and invasive monitoring via arterial, pulmonary artery or cardiovascular catheters were not identified as risk factors.Conclusions:Our findings can be used to track postoperative mortality rates and to test preventative interventions at our institution and elsewhere.

Incidence and causes of perioperative mortality after primary surgery for intracranial tumors: a national, population-based study

“…It is known that the total risk of perioperative death is related to patient age, type of surgery, and American Society of Anesthesiologists physical status of the patient. 12 Our results indicate that in patients with primary intracranial tumors, the type of lesion is also significantly related to the risk of perioperative death. Technically challenging operations have no clear excess risk, but instead higher risks were associated with histopathological groups with overall poor long-term prognosis.…”

Surgical Emergency- A View of a Developing Institute

“…An emergency procedure within 48 hours was imparted approximately 8 times increase risk of mortality and 3 times increase risk of death in 30 days post operatively. [11] Postoperative ICU admission was associated with 2-3 times increased risk of 48 hours and 30 day post operative mortality.…”

“…Patient who developed SSI are likely to have twice mortality rate, 60% more likely to spend time in an ICU and more than 5 times more likely to be readmitted to the hospital. [11,12] In 1989 according to the most cited report peri operative death directly contributed to aesthesia management is 0.0001% for generally fit persons. [7] The numbers of death in high, middle and low socio economic countries are variable in post emergency abdominal operations Surgical mortality data are collected routinely in high income countries.…”

The association of time of emergency surgery – day, evening or night – with postoperative 30‐day hospital mortality

“…Many researchers have tried to identify factors associated with increased mortality after anaesthesia and surgery . Some pre‐operative variables are associated with postoperative in‐hospital mortality, including emergency surgery, age and ASA physical status .…”

“…Many researchers have tried to identify factors associated with increased mortality after anaesthesia and surgery . Some pre‐operative variables are associated with postoperative in‐hospital mortality, including emergency surgery, age and ASA physical status . The time of day when surgery takes place might also be associated with mortality , as it is for rates of vocational accidents and driving accidents and some medical outcomes .…”