Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: a prospective follow-up study

OBJECTIVE: This study aimed to assess the incidence and identify predictors of perioperative mortality among the adult age group at Tibebe Ghion Specialised Hospital. DESIGN: A single-centre prospective follow-up study. SETTING: A tertiary hospital in North West Ethiopia. PARTICIPANTS: We enrolled 2530 participants who underwent surgery in the current study. All adults aged 18 and above were included except those with no telephone. PRIMARY OUTCOME MEASURES: The primary outcome was time to death measured in days from immediate postoperative time up to the 28th day following surgery. RESULT: A total of 2530 surgical cases were followed for 67 145 person-days. There were 92 deaths, with an incidence rate of 1.37 (95% CI 1.11 to 1.68) deaths per 1000 person-day observations. Regional anaesthesia was significantly associated with lower postoperative mortality (adjusted hazard ratio (AHR) 0.18, 95% CI 0.05 to 0.62). Patients aged ≥65 years (AHR 3.04, 95% CI 1.65 to 5.75), American Society of Anesthesiologist (ASA) physical status III (AHR 2.41, 95% CI 1.1.13 to 5.16) and IV (AHR 2.74, 95% CI 1.08 to 6.92), emergency surgery (AHR 1.85, 95% CI 1.02 to 3.36) and preoperative oxygen saturation <95% (AHR 3.14, 95% CI 1.85 to 5.33) were significantly associated with a higher risk of postoperative mortality. CONCLUSION: The postoperative mortality rate at Tibebe Ghion Specialised Hospital was high. Age ≥65, ASA physical status III and IV, emergency surgery, and preoperative oxygen saturation <95% were significant predictors of postoperative mortality. Patients with the identified predictors should be offered targeted treatment.