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. 2024 Aug 21;8(5):435-442.
doi: 10.1016/j.mayocpiqo.2024.07.002. eCollection 2024 Oct.

Perioperative Mortality: A Retrospective Cohort Study of 75,446 Noncardiac Surgery Patients

Gregory A Nuttall  1 , Michael P Merren  1 , Julian Naranjo  1 , Erica R Portner  1 , Amanda R Ambrose  1 , Charanjit S Rihal  2
Affiliations

Perioperative Mortality: A Retrospective Cohort Study of 75,446 Noncardiac Surgery Patients

Gregory A Nuttall et al. Mayo Clin Proc Innov Qual Outcomes. .

Abstract

Objective: To evaluate whether major adverse cardiac events (MACE) continue to be a major causative factor for mortality after noncardiac surgery.

Patients and methods: We performed retrospective study of 75,410 adult noncardiac surgery patients at Mayo Clinic Rochester, between January 1, 2016, and May 4, 2018. Electronic medical records were reviewed and data collected on all deaths within 30 days (n=692 patients) of surgery. The incidence of death due to MACE was calculated.

Results: Postoperative MACE occurred in 150 patients (21.4 events per 10,000 patients; 95% CI, 18.2-25.2 events per 10,000 patients) with most occurring within 3 days of surgery (n=113). Postoperative MACE events were associated with atrial fibrillation with rapid rate response in 25 patients (16.7%), sepsis in 15 patients (10%), and bleeding in 15 patients (10%). There were 12 intraoperative deaths of which 9 were due to exsanguination (75%) and the remaining 3 (25%) due to cardiac arrest. Of the 56 deaths on the first 24 hours after surgery, 7 were due to hemorrhage, 17 due to cardiovascular causes, 20 due to sepsis, and 7 due to neurologic disease. The leading cause of total death over 30 days postoperatively was sepsis (28%), followed by malignancy (27%), cardiovascular disease (12%) neurologic disease (12%), and hemorrhage (5%).

Conclusion: MACE was not the leading cause of death both intraoperatively and postoperatively.

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Conflict of interest statement

The authors report no competing interests.

Figures

Figure
Figure
Consolidated Standards of Reporting Trials (CONSORT) diagram describing the flow of patients through the study.
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References

    1. Weiser T.G., Haynes A.B., Molina G., et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015;385(Suppl 2) doi: 10.1016/S0140-6736(15)60806-6. - DOI - PubMed
    1. Kable A.K., Gibberd R.W., Spigelman A.D. Adverse events in surgical patients in Australia. Int J Qual Health Care. 2002;14(4):269–276. doi: 10.1093/intqhc/14.4.269. - DOI - PubMed
    1. Mullen R., Scollay J.M., Hecht G., McPhillips G., Thompson A.M. Death within 48 h—adverse events after general surgical procedures. Surgeon. 2012;10(1):1–5. doi: 10.1016/j.surge.2011.01.005. - DOI - PubMed
    1. Pearse R.M., Moreno R.P., Bauer P., et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012;380(9847):1059–1065. doi: 10.1016/S0140-6736(12)61148-9. - DOI - PMC - PubMed
    1. International Surgical Outcomes Study Group Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016;117(5):601–609. doi: 10.1093/bja/aew316. - DOI - PMC - PubMed

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