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Perioperative Complications Are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery

dc.contributor.authorTjeertes, E
dc.contributor.authorUltee, K
dc.contributor.authorStolker, R
dc.contributor.authorVerhagen, H
dc.contributor.authorBastos Gonçalves, F
dc.contributor.authorHoofwijk, A
dc.contributor.authorHoeks, S
dc.date.accessioned2018-01-23T16:07:21Z
dc.date.available2018-01-23T16:07:21Z
dc.date.issued2016
dc.description.abstractBACKGROUND: It is unclear how mortality and causes of death vary between patients and surgical procedures and how occurrence of postoperative complications is associated with prognosis. This study describes long-term mortality rates and causes of death in a general surgical population. Furthermore, we explore the effect of postoperative complications on mortality. METHODS: A single-centre analysis of postoperative complications, with mortality as primary endpoint, was conducted in 4479 patients undergoing surgery. We applied univariate and multivariable regression models to analyse the effect of risk factors, including surgical risk and postoperative complications, on mortality. Causes of death were also explored. RESULTS: 75 patients (1.7 %) died within 30 days after surgery and 730 patients (16.3 %) died during a median follow-up of 6.3 years (IQR 5.8-6.8). Significant differences in long-term mortality were observed with worst outcome for patients undergoing high-risk vascular surgery (HR 1.5; 95 % CI 1.2-1.9). When looking at causes of death, high-risk surgery was associated with a twofold higher risk of cardiovascular death (HR 1.9; 95 % CI 1.2-3.1), whereas the intermediate-risk group had a higher risk of dying from cancer-related causes (HR 1.5; 95 % CI 1.1-2.0). Occurrence of complications-particularly of cardiovascular nature- was associated with worse survival (HR 1.9; 95 % CI 1.3-2.7). CONCLUSION: High-risk vascular surgery and occurrence of postoperative complications are important predictors of late mortality. Further focus on these groups of patients can contribute to reduced morbidity. Improvement in quality of care should be aimed at preventing postoperative complications and thus a better outcome in a general surgical population.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationWorld J Surg. 2016 Nov;40(11):2581-2590.pt_PT
dc.identifier.doi10.1007/s00268-016-3600-4pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2854
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAdultpt_PT
dc.subjectAgedpt_PT
dc.subjectCardiovascular Diseasespt_PT
dc.subjectFemalept_PT
dc.subjectGeneral Surgerypt_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectNeoplasmspt_PT
dc.subjectNetherlandspt_PT
dc.subjectPostoperative Complicationspt_PT
dc.subjectPrognosispt_PT
dc.subjectRisk Factorspt_PT
dc.subjectTime Factorspt_PT
dc.subjectVascular Surgical Procedurespt_PT
dc.subjectCause of Deathpt_PT
dc.subjectHSM CIR VASCpt_PT
dc.titlePerioperative Complications Are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgerypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2590pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage2581pt_PT
oaire.citation.titleWorld Journal of Surgerypt_PT
oaire.citation.volume40pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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