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Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies
BACKGROUND: Complications after surgery affect survival and quality of life. We aimed to confirm the relationship between postoperative complications and death within 1 yr after surgery. METHODS: We conducted a secondary analysis of pooled data from two prospective cohort studies of patients undergo...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575043/ https://www.ncbi.nlm.nih.gov/pubmed/35989114 http://dx.doi.org/10.1016/j.bja.2022.06.019 |
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author | Fowler, Alexander J. Wan, Yize I. Prowle, John R. Chew, Michelle Campbell, Douglas Cuthbertson, Brian Wijeysundera, Duminda N. Pearse, Rupert Abbott, Tom |
author_facet | Fowler, Alexander J. Wan, Yize I. Prowle, John R. Chew, Michelle Campbell, Douglas Cuthbertson, Brian Wijeysundera, Duminda N. Pearse, Rupert Abbott, Tom |
author_sort | Fowler, Alexander J. |
collection | PubMed |
description | BACKGROUND: Complications after surgery affect survival and quality of life. We aimed to confirm the relationship between postoperative complications and death within 1 yr after surgery. METHODS: We conducted a secondary analysis of pooled data from two prospective cohort studies of patients undergoing surgery in five high-income countries between 2012 and 2014. Exposure was any complication within 30 days after surgery. Primary outcome was death within 1 yr after surgery, ascertained by direct follow-up or linkage to national registers. We adjusted for clinically important covariates using a mixed-effect multivariable Cox proportional hazards regression model. We conducted a planned subgroup analysis by type of complication. Data are presented as mean with standard deviation (sd), n (%), and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). RESULTS: The pooled cohort included 10 132 patients. After excluding 399 (3.9%) patients with missing data or incomplete follow-up, 9733 patients were analysed. The mean age was 59 [sd 16.8] yr, and 5362 (55.1%) were female. Of 9733 patients, 1841 (18.9%) had complications within 30 days after surgery, and 319 (3.3%) died within 1 yr after surgery. Of 1841 patients with complications, 138 (7.5%) died within 1 yr after surgery compared with 181 (2.3%) of 7892 patients without complications (aHR 1.94 [95% CI: 1.53–2.46]). Respiratory failure was associated with the highest risk of death, resulting in six deaths amongst 28 patients (21.4%). CONCLUSIONS: Postoperative complications are associated with increased mortality at 1 yr. Further research is needed to identify patients at risk of complications and to reduce mortality. |
format | Online Article Text |
id | pubmed-9575043 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-95750432022-10-18 Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies Fowler, Alexander J. Wan, Yize I. Prowle, John R. Chew, Michelle Campbell, Douglas Cuthbertson, Brian Wijeysundera, Duminda N. Pearse, Rupert Abbott, Tom Br J Anaesth Quality and Patient Safety BACKGROUND: Complications after surgery affect survival and quality of life. We aimed to confirm the relationship between postoperative complications and death within 1 yr after surgery. METHODS: We conducted a secondary analysis of pooled data from two prospective cohort studies of patients undergoing surgery in five high-income countries between 2012 and 2014. Exposure was any complication within 30 days after surgery. Primary outcome was death within 1 yr after surgery, ascertained by direct follow-up or linkage to national registers. We adjusted for clinically important covariates using a mixed-effect multivariable Cox proportional hazards regression model. We conducted a planned subgroup analysis by type of complication. Data are presented as mean with standard deviation (sd), n (%), and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). RESULTS: The pooled cohort included 10 132 patients. After excluding 399 (3.9%) patients with missing data or incomplete follow-up, 9733 patients were analysed. The mean age was 59 [sd 16.8] yr, and 5362 (55.1%) were female. Of 9733 patients, 1841 (18.9%) had complications within 30 days after surgery, and 319 (3.3%) died within 1 yr after surgery. Of 1841 patients with complications, 138 (7.5%) died within 1 yr after surgery compared with 181 (2.3%) of 7892 patients without complications (aHR 1.94 [95% CI: 1.53–2.46]). Respiratory failure was associated with the highest risk of death, resulting in six deaths amongst 28 patients (21.4%). CONCLUSIONS: Postoperative complications are associated with increased mortality at 1 yr. Further research is needed to identify patients at risk of complications and to reduce mortality. Elsevier 2022-10 2022-08-19 /pmc/articles/PMC9575043/ /pubmed/35989114 http://dx.doi.org/10.1016/j.bja.2022.06.019 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Quality and Patient Safety Fowler, Alexander J. Wan, Yize I. Prowle, John R. Chew, Michelle Campbell, Douglas Cuthbertson, Brian Wijeysundera, Duminda N. Pearse, Rupert Abbott, Tom Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
title | Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
title_full | Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
title_fullStr | Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
title_full_unstemmed | Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
title_short | Long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
title_sort | long-term mortality following complications after elective surgery: a secondary analysis of pooled data from two prospective cohort studies |
topic | Quality and Patient Safety |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575043/ https://www.ncbi.nlm.nih.gov/pubmed/35989114 http://dx.doi.org/10.1016/j.bja.2022.06.019 |
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