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Associations Between Preoperative Risk, Postoperative Complications, and 30-Day Mortality

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Abstract

Background

Comorbidities and postoperative complications increase mortality, making early recognition and management critical. It is useful to understand how they are associated with one another. This study assesses associations between comorbidities, complications, and mortality.

Methods

We calculated associations between comorbidities, complications, and 30-day mortality using the 2012–2018 ACS-NSQIP database. We examined the association between mortality and number of complications which complications were most associated with mortality.

Results

5,777,108 patients were included. 30-day mortality was 0.95%. For most comorbidities or postoperative complications, patients with these had higher mortality than patients without. Having ≥ 1 complication increased mortality risk by 32.5-fold (6.5% vs. 0.2%). Mortality rate significantly increased with increasing number of complications, particularly after two or more complications. Bleeding and sepsis were associated with the most deaths.

Conclusion

The 30-day mortality rate was < 1% but was 32-fold higher in patients with complications and increased rapidly for patients with ≥ 2 complications. Bleeding and sepsis were the most prominent complications associated with mortality.

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Acknowledgements

The ACS NSQIP and participating hospitals are the source of these data; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

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Authors and Affiliations

  1. Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Helen J. Madsen, William G. Henderson, Michael R. Bronsert, Adam R. Dyas, Kathryn L. Colborn, Anne Lambert-Kerzner & Robert A. Meguid

  2. Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA

    William G. Henderson, Michael R. Bronsert, Anne Lambert-Kerzner & Robert A. Meguid

  3. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA

    William G. Henderson & Kathryn L. Colborn

  4. Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Denver, Anschutz Medical Campus, 12631 E. 17th Avenue, C-310, Room 6602, Aurora, CO, 80045, USA

    Helen J. Madsen

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  1. Helen J. Madsen
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  2. William G. Henderson
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  3. Michael R. Bronsert
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  4. Adam R. Dyas
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  5. Kathryn L. Colborn
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  6. Anne Lambert-Kerzner
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  7. Robert A. Meguid
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Corresponding author

Correspondence to Helen J. Madsen.

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The authors have no conflicts of interest to declare.

Informed consent

The Colorado Multiple Institutional Review Board determined this study exempt from review as it used publicly available deidentified data.

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Madsen, H.J., Henderson, W.G., Bronsert, M.R. et al. Associations Between Preoperative Risk, Postoperative Complications, and 30-Day Mortality. World J Surg 46, 2365–2376 (2022). https://doi.org/10.1007/s00268-022-06638-2

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  • DOI: https://doi.org/10.1007/s00268-022-06638-2

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