The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery

Vital healthcare resources are devoted to caring for patients with prolonge d hospitalization after routine, moderate-risk surgery. Despite the signifi cant cost,little is known about the overall incidence and pattern of compli cations in these patients. Four hundred thirty-eight patients undergoing a diverse group of routine, moderate-risk, elective surgical procedures were enrolled into a prospective, blinded, cohort study. Complications were asse ssed using a postoperative morbidity survey. The main outcome was postopera tive complication, defined as either in-hospital death or prolonged postope rative hospitalization (>7 days). The mortality rate was 1.6%. Postoperativ e complications occurred in 118 patients (27% [95% CI 23-31]). Complication s frequently observed in these patients included: gastrointestinal 51% (42- 60), pulmonary 25% (17-33), renal 21% (14-28), and infectious 13% (7-19). M ost complications were not directly related to the type/site of surgery. in dices of tissue trauma (blood loss [P < 0.001], surgical duration [P = 0.00 1]) and tissue perfusion (arterial base deficit [P = 0.008], gastric pHi [P = 0.02]) were the strongest intraoperative predictors of complications. De spite a low mortality rate, we found that complications after routine, mode rate-risk, elective surgery are common and involve multiple organ systems. Our 9-point survey can be used by healthcare providers and payers to charac terize postoperative morbidity in their respective settings. Implications: Little is known about the overall incidence and pattern of complications in patients with prolonged hospitalization after routine, elective surgery. W e prospectively assessed these complications using a novel postoperative mo rbidity survey. The postoperative morbidity survey can be used in future cl inical outcome trials, as well as in routine hospital-based quality assuran ce.