Anesthesia & Analgesia. 89(2):514-519, AUGUST 1999

DOI: 10.1213/00000539-199908000-00050

,  

Issn Print: 0003-2999

Publication Date: August 1999


Share this on facebook   Share this on Twitter   Share this on LinkedIn   Email this article  



Print

The Use of a Postoperative Morbidity Survey to Evaluate Patients with Prolonged Hospitalization After Routine, Moderate-Risk, Elective Surgery

E. Bennett-Guerrero;I. Welsby;T. J. Dunn;L. R. Young;T. A. Wahl;T. L. Diers;B. G. Phillips-Bute;M. F. Newman;M. G. Mythen;

+ Author Information


    loading  Checking for direct PDF access through Ovid

Abstract

Vital healthcare resources are devoted to caring for patients with prolonged hospitalization after routine, moderate-risk surgery. Despite the significant cost, little is known about the overall incidence and pattern of complications 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 assessed using a postoperative morbidity survey. The main outcome was postoperative complication, defined as either in-hospital death or prolonged postoperative hospitalization (>7 days). The mortality rate was 1.6%. Postoperative complications occurred in 118 patients (27% [95% CI 23-31]). Complications frequently observed in these patients included: gastrointestinal 51% (42-60), pulmonary 25% (17-33), renal 21% (14-28), and infectious 13% (7-19). Most complications were not directly related to the type/site of surgery. Indices of tissue trauma (blood loss [P < 0.001], surgical duration [P = 0.001]) and tissue perfusion (arterial base deficit [P = 0.008], gastric pHi [P = 0.02]) were the strongest intraoperative predictors of complications. Despite a low mortality rate, we found that complications after routine, moderate-risk, elective surgery are common and involve multiple organ systems. Our 9-point survey can be used by healthcare providers and payers to characterize 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. We prospectively assessed these complications using a novel postoperative morbidity survey. The postoperative morbidity survey can be used in future clinical outcome trials, as well as in routine hospital-based quality assurance.(Anesth Analg 1999;89:514-9)

Related Topics

    Related Articles

        loading  Loading Related Articles