Dataset Information

Survival after postoperative morbidity: a longitudinal observational cohort study.

ABSTRACT:

Background

Previous studies have suggested that there may be long-term harm associated with postoperative complications. Uncertainty exists however, because of the need for risk adjustment and inconsistent definitions of postoperative morbidity.

Methods

We did a longitudinal observational cohort study of patients undergoing major surgery. Case-mix adjustment was applied and morbidity was recorded using a validated outcome measure. Cox proportional hazards modelling using time-dependent covariates was used to measure the independent relationship between prolonged postoperative morbidity and longer term survival.

Results

Data were analysed for 1362 patients. The median length of stay was 9 days and the median follow-up time was 6.5 yr. Independent of perioperative risk, postoperative neurological morbidity (prevalence 2.9%) was associated with a relative hazard for long-term mortality of 2.00 [P=0.001; 95% confidence interval (CI) 1.32-3.04]. Prolonged postoperative morbidity (prevalence 15.6%) conferred a relative hazard for death in the first 12 months after surgery of 3.51 (P<0.001; 95% CI 2.28-5.42) and for the next 2 yr of 2.44 (P<0.001; 95% CI 1.62-3.65), returning to baseline thereafter.

Conclusions

Prolonged morbidity after surgery is associated with a risk of premature death for a longer duration than perhaps is commonly thought; however, this risk falls with time. We suggest that prolonged postoperative morbidity measured in this way may be a valid indicator of the quality of surgical healthcare. Our findings reinforce the importance of research and quality improvement initiatives aimed at reducing the duration and severity of postoperative complications.

SUBMITTER: Moonesinghe SR

PROVIDER: S-EPMC4235571 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Publications

Survival after postoperative morbidity: a longitudinal observational cohort study.

Moonesinghe S R SR Harris S S Harris S S Mythen M G MG Rowan K M KM Haddad F S FS Emberton M M Grocott M P W MP

British journal of anaesthesia 20140710 6

<h4>Background</h4>Previous studies have suggested that there may be long-term harm associated with postoperative complications. Uncertainty exists however, because of the need for risk adjustment and inconsistent definitions of postoperative morbidity.<h4>Methods</h4>We did a longitudinal observational cohort study of patients undergoing major surgery. Case-mix adjustment was applied and morbidity was recorded using a validated outcome measure. Cox proportional hazards modelling using time-depe ...[more]

PMID: 25012586

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Dataset Information

Survival after postoperative morbidity: a longitudinal observational cohort study.

Background

Methods

Results

Conclusions

Publications

Survival after postoperative morbidity: a longitudinal observational cohort study.

Similar Datasets

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