E. Bennett-guerrero et al., The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery, ANESTH ANAL, 89(2), 1999, pp. 514-519
Citations number
32
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
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.