Journal of Gastrointestinal Surgery

, Volume 11, Issue 7, pp 903–910

Risk Factors for Mortality and Postoperative Complications After Gastrointestinal Surgery

  • Lars Tue Sørensen
  • Afshin Malaki
  • Peer Wille-Jørgensen
  • Finn Kallehave
  • Johan Kjærgaard
  • Ulla Hemmingsen
  • Lisbeth Nørgaard Møller
  • Torben Jørgensen
Article

DOI: 10.1007/s11605-007-0165-4

Cite this article as:
Sørensen, L.T., Malaki, A., Wille-Jørgensen, P. et al. J Gastrointest Surg (2007) 11: 903. doi:10.1007/s11605-007-0165-4

Abstract

Background

Predictors of a poor surgical outcome are numerous, of which some are well-defined. We aimed to assess risk factors predictive of poor surgical outcome across different gastrointestinal operations related to the patient, the disease, the treatment, and the organization of care.

Methods

Data from 5,255 unselected patients undergoing open gastrointestinal surgery from 1995 through 1998 was prospectively recorded in a clinical database and validated. The database embraced variables related to patient history, preoperative clinical condition, operative findings and complexity, and the surgeon’s training. Variables predictive of mortality and complications occurring within 30 days after surgery were assessed by multiple logistic regression analysis.

Results

After elective operation, the 30-day mortality was 2.8% and major complications occurred in 11.5% of the patients. The corresponding figures in emergency surgery were 13.8% and 30.1%. Independent of elective or emergency surgery, dependent functional status, and type of operation were associated with postoperative mortality. Comorbidity, type of operation, blood loss, and reoperation were predictors of complications regardless of elective or emergency operation. In elective surgery, predictors of poor surgical outcome were high age, comorbidity, malignancy, and the surgeons training, whereas abnormal vital signs values and peritonitis were predictors of poor outcome after emergency surgery.

Conclusion

Premorbid factors, characteristics of the disease, the patients’ preoperative condition, operative factors, and the surgeon’s training are all associated with surgical outcome across different gastrointestinal operations and should be assessed when auditing surgical outcome.

Keywords

Risk factorsMortalityPostoperative complicationsGeneral surgeryGastrointestinal surgery

Copyright information

© The Society for Surgery of the Alimentary Tract 2007

Authors and Affiliations

  • Lars Tue Sørensen
    • 1
  • Afshin Malaki
    • 1
  • Peer Wille-Jørgensen
    • 1
  • Finn Kallehave
    • 1
  • Johan Kjærgaard
    • 1
  • Ulla Hemmingsen
    • 1
  • Lisbeth Nørgaard Møller
    • 2
  • Torben Jørgensen
    • 2
  1. 1.Department of Surgical GastroenterologyBispebjerg HospitalCopenhagenDenmark
  2. 2.Research Centre for Prevention and HealthGlostrup Hospital, University of CopenhagenCopenhagenDenmark