One-year outcomes after discharge from noncardiac surgery and association between pre-discharge complications and death after discharge: analysis of the VISION  prospective cohort study.

Marcucci, Maura; McGillion, Michael; Popova, Ekaterine; Gregus, Krysten; Jacka, Michael J.; Fernández, Carmen; Sapsford, Robert; Biccard, Bruce M.; Lamy, André; Garg, Amit X.; Leong, Darryl P.; Panju, Mohamed; Polanczyk, Carísi A.; Cortés, Olga L.; Borges, Flavia K.; Sessler, Daniel I.; Málaga Rodríguez, Germán Javier; Patel, Ameen; Ackland, Gareth L.; Spence, Jessica; Villar, Juan Carlos; Ofori, Sandra; Roshanov, Pavel S.; Tandon, Vikas; Devereaux, P. J.; Heels-Ansdell, Diane; Alonso-Coello, Pablo; Chow, Clara K.; Sigamani, Alben; Conen, David; Pearse, Rupert M.; Tiboni, Maria; Wang, C. Y.; Belley-Côté, Emilie P.; McIntyre, William F.; Abraham, Valsa; Berwanger, Otavio; Wu, William Ka Kei; Srinathan, Sadeesh K.; MacNeil, S. Danielle; Xavier, Denis; Whitlock, Richard; Williams, Colin; Chan, Matthew T. V.; Szczeklik, Wojciech

dc.contributor.author	Roshanov, Pavel S.
dc.contributor.author	Chan, Matthew T. V.
dc.contributor.author	Borges, Flavia K.
dc.contributor.author	Conen, David
dc.contributor.author	Wang, C. Y.
dc.contributor.author	Xavier, Denis
dc.contributor.author	Berwanger, Otavio
dc.contributor.author	Marcucci, Maura
dc.contributor.author	Sessler, Daniel I.
dc.contributor.author	Szczeklik, Wojciech
dc.contributor.author	Spence, Jessica
dc.contributor.author	Alonso-Coello, Pablo
dc.contributor.author	Fernández, Carmen
dc.contributor.author	Pearse, Rupert M.
dc.contributor.author	Málaga Rodríguez, Germán Javier
dc.contributor.author	Garg, Amit X.
dc.contributor.author	Srinathan, Sadeesh K.
dc.contributor.author	Jacka, Michael J.
dc.contributor.author	Tandon, Vikas
dc.contributor.author	McGillion, Michael
dc.contributor.author	Popova, Ekaterine
dc.contributor.author	Sigamani, Alben
dc.contributor.author	Abraham, Valsa
dc.contributor.author	Biccard, Bruce M.
dc.contributor.author	Villar, Juan Carlos
dc.contributor.author	Chow, Clara K.
dc.contributor.author	Polanczyk, Carísi A.
dc.contributor.author	Tiboni, Maria
dc.contributor.author	Whitlock, Richard
dc.contributor.author	Ackland, Gareth L.
dc.contributor.author	Panju, Mohamed
dc.contributor.author	Lamy, André
dc.contributor.author	Sapsford, Robert
dc.contributor.author	Williams, Colin
dc.contributor.author	Wu, William Ka Kei
dc.contributor.author	Cortés, Olga L.
dc.contributor.author	MacNeil, S. Danielle
dc.contributor.author	Patel, Ameen
dc.contributor.author	Belley-Côté, Emilie P.
dc.contributor.author	Ofori, Sandra
dc.contributor.author	McIntyre, William F.
dc.contributor.author	Leong, Darryl P.
dc.contributor.author	Heels-Ansdell, Diane
dc.contributor.author	Gregus, Krysten
dc.contributor.author	Devereaux, P. J.
dc.date.accessioned	2023-10-12T15:30:08Z
dc.date.available	2023-10-12T15:30:08Z
dc.date.issued	2023
dc.identifier.uri	https://hdl.handle.net/20.500.12866/14289
dc.description.abstract	BACKGROUND: In prior analyses, myocardial injury after noncardiac surgery, major bleeding, and sepsis were independently associated with most deaths in the 30 days after noncardiac surgery, but most of these deaths occurred during the index hospitalization for surgery. We set out to describe outcomes after discharge from hospital up to one year after inpatient noncardiac surgery and associations between pre-discharge complications and post-discharge death up to one year after surgery. METHODS: Analysis of patients discharged after inpatient noncardiac surgery in a large international prospective cohort study across 28 centers from 2007-2013 of patients aged ≥45 years followed to one year after surgery. We estimated 1) the cumulative post-discharge incidence of death and other outcomes up to a year after surgery and 2) the adjusted time-varying associations between post-discharge death and pre-discharge complications including myocardial injury after noncardiac surgery, major bleeding, sepsis, infection without sepsis, stroke, congestive heart failure, clinically important atrial fibrillation or flutter, amputation, venous thromboembolism, and acute kidney injury managed with dialysis. RESULTS: Among 38,898 patients discharged after surgery, the cumulative one-year incidence was 5.8% (95% CI, 5.5-6.0%) for all-cause death and 24.7% (24.2-25.1%) for all-cause hospital readmission. Pre-discharge complications were associated with 33.7% (27.2-40.2%) of deaths up to 30 days after discharge and 15.0% (12.0-17.9%) up to one year. Most of the association with death was due to myocardial injury after noncardiac surgery (15.6% [9.3-21.9%) of deaths within 30 days, 6.4% [4.1-8.7%] within one year), major bleeding (15.0% [8.3-21.7%] within 30 days, 4.7% [2.2-7.2%] within one year), and sepsis (5.4% [2.2-8.6%] within 30 days, 2.1% [1.0-3.1%] within one year). CONCLUSIONS: One in 18 patients ≥45 years old discharged after inpatient noncardiac surgery died within one year and one quarter were readmitted to hospital. The risk of death associated with pre-discharge perioperative complications persists for weeks to months after discharge.	en_US
dc.language.iso	eng
dc.publisher	Wolters Kluwer Health
dc.relation.ispartofseries	Anesthesiology
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Prospective studies	en_US
dc.subject	Surgical procedures	en_US
dc.subject	Operative	en_US
dc.subject	Vision	en_US
dc.subject.mesh	Estudios Prospectivos
dc.subject.mesh	Procedimientos Quirúrgicos Operativos
dc.subject.mesh	Visión Ocular
dc.title	One-year outcomes after discharge from noncardiac surgery and association between pre-discharge complications and death after discharge: analysis of the VISION prospective cohort study.	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1097/ALN.0000000000004763
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.09
dc.relation.issn	1528-1175