PEROPERATIVE AND IMMEDIATE POSTOPERATIVE ADVERSE EVENTS IN PATIENTS UNDERGOING ELECTIVE GENERAL AND ORTHOPEDIC-SURGERY - THE GOTHENBURG STUDY OF PERIOPERATIVE RISK (PROPER) .2.

All anaesthetic and surgical procedures impose a certain risk of compl ications. However, reliable estimates of this risk from prospective st udies are rare. This study is a prospective clinical epidemiological s tudy of 1361 consecutive patients subjected to elective general and or thopaedic surgery. These patients were followed from an extensive preo perative assessment to three months after the operation. In this repor t the peroperative and early postoperative period in the postoperative care unit or intensive care unit is described. General anaesthesia wa s given to 59% and regional/local anaesthesia to 41%. Adverse peropera tive events occurred in 19%. The most common were circulatory events ( 11%), respiratory (4%), and allergic events (1%). Most Events were of minor severity. However, with the official registration system, only 1 out of 8 events was detected. In the postoperative unit one or more a dverse event was noted in 47% of the cases. These were dominated by ci rculatory (18.4%) and respiratory events (5.0%). CNS depression was no ted in 6.8% of the cases. Most per- and postoperative event variables were highly correlated to the degree of surgical stress. In conclusion , a new concept for preoperative assessment and the registration of ev ents during and after surgery was used. In this way, a large number of events of importance, not least for quality assurance, were found tha t would be missed with the official coding system. In a previous repor t we could show that even minor events affected the cost of care subst antially.