Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 23;7(1):9221.
doi: 10.1038/s41598-017-09833-7.

Short and Long-Term Outcomes After Surgical Procedures Lasting for More Than Six Hours

Natalia Cornellà  1 , Joan Sancho  1 , Antonio Sitges-Serra  2
Affiliations

Short and Long-Term Outcomes After Surgical Procedures Lasting for More Than Six Hours

Natalia Cornellà et al. Sci Rep. .

Abstract

Long-term all-cause mortality and dependency after complex surgical procedures have not been assessed in the framework of value-based medicine. The aim of this study was to investigate the postoperative and long-term outcomes after surgical procedures lasting for more than six hours. Retrospective cohort study of patients undergoing a first elective complex surgical procedure between 2004 and 2013. Heart and transplant surgery was excluded. Mortality and dependency from the healthcare system were selected as outcome variables. Gender, age, ASA, creatinine, albumin kinetics, complications, benign vs malignant underlying condition, number of drugs at discharge, and admission and length of stay in the ICU were recorded as predictive variables. Some 620 adult patients were included in the study. Postoperative, <1year and <5years cumulative mortality was 6.8%, 17.6% and 45%, respectively. Of patients discharged from hospital after surgery, 76% remained dependent on the healthcare system. In multivariate analysis for postoperative, <1year and <5years mortality, postoperative albumin concentration, ASA score and an ICU stay >7days, were the most significant independent predictive variables. Prolonged surgery carries a significant short and long-term mortality and disability. These data may contribute to more informed decisions taken concerning major surgery in the framework of value-based medicine.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests that could have influenced their work. The resources and facilities of the of the Hospital del Mar were used in conducting this study. There was no additional source of funding.

Figures

Figure 1
Figure 1
Flow chart of patients included in the study.
Figure 2
Figure 2
Association between all-cause mortality within one year of surgery and postoperative albumin concentrations.
Figure 3
Figure 3
Serum albumin concentrations (pre-, post- and drop) in different ASA categories.
See this image and copyright information in PMC

References

    1. World Health Organization. www.who.int/gho/publications/world_health_statistics/2016/whs2016_highli... (2016). Accessed 17.06.16.
    1. Fundación Banco Bilbao Vizcaya. www.fbbva.es/TLFU/dat/DT_2006_11.pdf (2016). Accessed 17.06.16.
    1. Diario Expansión. www.datosmacro.com/estado/gasto/salud/espana (2016). Accessed 10.06.16.
    1. Institut National de la statistique et des études économiques. www.insee.fr/fr/default.asp (2016). Accessed 10.06.16.
    1. Brown MM, Brown GC. Update on value-based medicine. Curr Opin Ophtalmol. 2013;24:183–189. doi: 10.1097/ICU.0b013e32835ff189. - DOI - PubMed