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Half of Deaths After Noncardiac Surgery Due to 3 Complications

MONDAY, July 29, 2019 -- Three complications account for almost 45 percent of deaths occurring after noncardiac surgery, according to a study published in the July 29 issue of CMAJ, the journal of the Canadian Medical Association.

Jessica Spence, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a prospective cohort study of patients aged 45 years and older who underwent inpatient noncardiac surgery at 28 centers in 14 countries to examine the frequency and timing of death and its association with perioperative complications. Patients were monitored for complications until 30 days after surgery; the correlation between complications and 30-day mortality was assessed among 40,004 patients.

The researchers found that 1.8 percent of the patients died within 30 days of surgery. Overall, 0.7, 69.9, and 29.4 percent of deaths occurred in the operating room, after surgery during the index admission to the hospital, and after discharge from the hospital, respectively. Independent associations were found between eight complications and 30-day mortality. Major bleeding, myocardial injury after noncardiac surgery, and sepsis had the largest attributable fractions (adjusted hazard ratios, 2.6, 2.2, and 5.6, respectively; attributable fractions, 17.0, 15.9, and 12.0 percent, respectively).

"These complications are promising targets for research on prevention, early identification and management to decrease perioperative mortality," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: July 2019

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