Universidad Peruana Cayetano Heredia

Association between complications and death within 30 days after noncardiac surgery

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dc.contributor.author Spence, J.
dc.contributor.author LeManach, Y.
dc.contributor.author Chan, M.T.V.
dc.contributor.author Wang, C.Y.
dc.contributor.author Sigamani, A.
dc.contributor.author Xavier, D.
dc.contributor.author Pearse, R.
dc.contributor.author Alonso-Coello, P.
dc.contributor.author Garutti, I.
dc.contributor.author Srinathan, S.K.
dc.contributor.author Duceppe, E.
dc.contributor.author Walsh, M.
dc.contributor.author Borges, F.K.
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Abraham, V.
dc.contributor.author Faruqui, A.
dc.contributor.author Berwanger, O.
dc.contributor.author Biccard, B.M.
dc.contributor.author Villar, J.C.
dc.contributor.author Sessler, D.I.
dc.contributor.author Kurz, A.
dc.contributor.author Chow, C.K.
dc.contributor.author Polanczyk, C.A.
dc.contributor.author Szczeklik, W.
dc.contributor.author Ackland, G.
dc.contributor.author Garg, A.X.
dc.contributor.author Jacka, M.
dc.contributor.author Guyatt, G.H.
dc.contributor.author Sapsford, R.J.
dc.contributor.author Williams, C.
dc.contributor.author Cortes, O.L.
dc.contributor.author Coriat, P.
dc.contributor.author Patel, A.
dc.contributor.author Tiboni, M.
dc.contributor.author Belley-Côté, E.P.
dc.contributor.author Yang, S.
dc.contributor.author Heels-Ansdell, D.
dc.contributor.author McGillion, M.
dc.contributor.author Schünemann, H.J.
dc.contributor.author Parlow, S.
dc.contributor.author Patel, M.
dc.contributor.author Pettit, S.
dc.contributor.author Yusuf, S.
dc.contributor.author Devereaux, P.J.
dc.contributor.author VISION Investigators
dc.date.accessioned 2019-12-06T21:04:51Z
dc.date.available 2019-12-06T21:04:51Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7649
dc.description.abstract BACKGROUND: Among adults undergoing contemporary noncardiac surgery, little is known about the frequency and timing of death and the associations between perioperative complications and mortality. We aimed to establish the frequency and timing of death and its association with perioperative complications. METHODS: We conducted a prospective cohort study of patients aged 45 years and older who underwent inpatient noncardiac surgery at 28 centres in 14 countries. We monitored patients for complications until 30 days after surgery and determined the relation between these complications and 30-day mortality using a Cox proportional hazards model. RESULTS: We included 40004 patients. Of those, 715 patients (1.8%) died within 30 days of surgery. Five deaths (0.7%) occurred in the operating room, 500 deaths (69.9%) occurred after surgery during the index admission to hospital and 210 deaths (29.4%) occurred after discharge from the hospital. Eight complications were independently associated with 30-day mortality. The 3 complications with the largest attributable fractions (AF; i.e., potential proportion of deaths attributable to these complications) were major bleeding (6238 patients, 15.6%; adjusted hazard ratio [HR] 2.6, 95% confidence interval [CI] 2.2–3.1; AF 17.0%); myocardial injury after noncardiac surgery [MINS] (5191 patients, 13.0%; adjusted HR 2.2, 95% CI 1.9–2.6; AF 15.9%); and sepsis (1783 patients, 4.5%; adjusted HR 5.6, 95% CI 4.6–6.8; AF 12.0%). INTERPRETATION: Among adults undergoing noncardiac surgery, 99.3% of deaths occurred after the procedure and 44.9% of deaths were associated with 3 complications: major bleeding, MINS and sepsis. Given these findings, focusing on the prevention, early identification and management of these 3 complications holds promise for reducing perioperative mortality. en_US
dc.language.iso eng
dc.publisher Canadian Medical Association
dc.relation.ispartofseries CMAJ. Canadian Medical Association Journal
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject human en_US
dc.subject Article en_US
dc.subject controlled study en_US
dc.subject female en_US
dc.subject male en_US
dc.subject adult en_US
dc.subject cohort analysis en_US
dc.subject major clinical study en_US
dc.subject outcome assessment en_US
dc.subject risk reduction en_US
dc.subject mortality rate en_US
dc.subject mortality risk en_US
dc.subject prospective study en_US
dc.subject aged en_US
dc.subject disease association en_US
dc.subject hospital admission en_US
dc.subject sepsis en_US
dc.subject early diagnosis en_US
dc.subject early intervention en_US
dc.subject heart muscle injury en_US
dc.subject hospital discharge en_US
dc.subject multicenter study (topic) en_US
dc.subject noncardiac surgery en_US
dc.subject operative blood loss en_US
dc.subject patient monitoring en_US
dc.subject peroperative complication en_US
dc.subject surgical mortality en_US
dc.subject surgical technique en_US
dc.title Association between complications and death within 30 days after noncardiac surgery en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1503/cmaj.190221
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00
dc.relation.issn 1488-2329


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