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Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery

BACKGROUND: It is unclear how mortality and causes of death vary between patients and surgical procedures and how occurrence of postoperative complications is associated with prognosis. This study describes long-term mortality rates and causes of death in a general surgical population. Furthermore,...

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Autores principales: Tjeertes, Elke K.M., Ultee, K. H. J., Stolker, R. J., Verhagen, H. J. M., Bastos Gonçalves, F. M., Hoofwijk, A. G. M., Hoeks, S. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073115/
https://www.ncbi.nlm.nih.gov/pubmed/27302465
http://dx.doi.org/10.1007/s00268-016-3600-4
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author Tjeertes, Elke K.M.
Ultee, K. H. J.
Stolker, R. J.
Verhagen, H. J. M.
Bastos Gonçalves, F. M.
Hoofwijk, A. G. M.
Hoeks, S. E.
author_facet Tjeertes, Elke K.M.
Ultee, K. H. J.
Stolker, R. J.
Verhagen, H. J. M.
Bastos Gonçalves, F. M.
Hoofwijk, A. G. M.
Hoeks, S. E.
author_sort Tjeertes, Elke K.M.
collection PubMed
description BACKGROUND: It is unclear how mortality and causes of death vary between patients and surgical procedures and how occurrence of postoperative complications is associated with prognosis. This study describes long-term mortality rates and causes of death in a general surgical population. Furthermore, we explore the effect of postoperative complications on mortality. METHODS: A single-centre analysis of postoperative complications, with mortality as primary endpoint, was conducted in 4479 patients undergoing surgery. We applied univariate and multivariable regression models to analyse the effect of risk factors, including surgical risk and postoperative complications, on mortality. Causes of death were also explored. RESULTS: 75 patients (1.7 %) died within 30 days after surgery and 730 patients (16.3 %) died during a median follow-up of 6.3 years (IQR 5.8–6.8). Significant differences in long-term mortality were observed with worst outcome for patients undergoing high-risk vascular surgery (HR 1.5; 95 % CI 1.2–1.9). When looking at causes of death, high-risk surgery was associated with a twofold higher risk of cardiovascular death (HR 1.9; 95 % CI 1.2–3.1), whereas the intermediate-risk group had a higher risk of dying from cancer-related causes (HR 1.5; 95 % CI 1.1–2.0). Occurrence of complications—particularly of cardiovascular nature— was associated with worse survival (HR 1.9; 95 % CI 1.3–2.7). CONCLUSION: High-risk vascular surgery and occurrence of postoperative complications are important predictors of late mortality. Further focus on these groups of patients can contribute to reduced morbidity. Improvement in quality of care should be aimed at preventing postoperative complications and thus a better outcome in a general surgical population.
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spelling pubmed-50731152016-11-03 Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery Tjeertes, Elke K.M. Ultee, K. H. J. Stolker, R. J. Verhagen, H. J. M. Bastos Gonçalves, F. M. Hoofwijk, A. G. M. Hoeks, S. E. World J Surg Original Scientific Report BACKGROUND: It is unclear how mortality and causes of death vary between patients and surgical procedures and how occurrence of postoperative complications is associated with prognosis. This study describes long-term mortality rates and causes of death in a general surgical population. Furthermore, we explore the effect of postoperative complications on mortality. METHODS: A single-centre analysis of postoperative complications, with mortality as primary endpoint, was conducted in 4479 patients undergoing surgery. We applied univariate and multivariable regression models to analyse the effect of risk factors, including surgical risk and postoperative complications, on mortality. Causes of death were also explored. RESULTS: 75 patients (1.7 %) died within 30 days after surgery and 730 patients (16.3 %) died during a median follow-up of 6.3 years (IQR 5.8–6.8). Significant differences in long-term mortality were observed with worst outcome for patients undergoing high-risk vascular surgery (HR 1.5; 95 % CI 1.2–1.9). When looking at causes of death, high-risk surgery was associated with a twofold higher risk of cardiovascular death (HR 1.9; 95 % CI 1.2–3.1), whereas the intermediate-risk group had a higher risk of dying from cancer-related causes (HR 1.5; 95 % CI 1.1–2.0). Occurrence of complications—particularly of cardiovascular nature— was associated with worse survival (HR 1.9; 95 % CI 1.3–2.7). CONCLUSION: High-risk vascular surgery and occurrence of postoperative complications are important predictors of late mortality. Further focus on these groups of patients can contribute to reduced morbidity. Improvement in quality of care should be aimed at preventing postoperative complications and thus a better outcome in a general surgical population. Springer International Publishing 2016-06-14 2016 /pmc/articles/PMC5073115/ /pubmed/27302465 http://dx.doi.org/10.1007/s00268-016-3600-4 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Scientific Report
Tjeertes, Elke K.M.
Ultee, K. H. J.
Stolker, R. J.
Verhagen, H. J. M.
Bastos Gonçalves, F. M.
Hoofwijk, A. G. M.
Hoeks, S. E.
Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery
title Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery
title_full Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery
title_fullStr Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery
title_full_unstemmed Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery
title_short Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery
title_sort perioperative complications are associated with adverse long-term prognosis and affect the cause of death after general surgery
topic Original Scientific Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073115/
https://www.ncbi.nlm.nih.gov/pubmed/27302465
http://dx.doi.org/10.1007/s00268-016-3600-4
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