Factors associated with posoperative mortality in high perioperative risk patients. Cohort study

  • Víctor Hugo González Cárdenas a. Hospital Universitario de La Samaritana. Bogotá, Colombia. b. Los Cobos Medical Center. Bogotá, Colombia. c. School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS). Bogotá, Colombia. d. Hospital Militar Central. Bogotá, Colombia. https://orcid.org/0000-0003-2193-1106
  • Ilia Marcela Jáuregui Romero Hospital Universitario de La Samaritana. Bogotá, Colombia.
  • Yonny Mena Méndez Hospital Universitario de La Samaritana. Bogotá, Colombia.
  • Paola Nathaly Silva Enríquez a. Hospital Universitario de La Samaritana. Bogotá, Colombia. b. Anesthesia and Resuscitation Program, School of Medicine, Universidad de La Sabana. Chía, Colombia.
  • Andrés Soler Sandoval a. Hospital Universitario de La Samaritana. Bogotá, Colombia. b. Anesthesia and Resuscitation Program, School of Medicine, Universidad de La Sabana. Chía, Colombia. c. Hospital Militar Central. Bogotá, Colombia.
Keywords: Mortality, Anesthesiology, Postoperative complications, Perioperative period, Perioperative care

Abstract

Introduction: Determining perioperative risk is part of the strategies implemented with the aim of reducing morbidity and mortality in the surgical population in the world. Although there is no established definition, high perioperative risk is associated with the group of patients with the highest disease burden.

Objective: To determine postoperative mortality and its associated factors in patients with high perioperative risk.

Methods: Analytical observational cohort study of high perioperative risk patients included in the database (n = 843) of the anesthesia program in a high complexity hospital in Colombia, between January 2011 and April 2018. Pre and postoperative variables were analyzed using uni and multivariate logistic regression per protocol. Overall and stratified mortality were estimated and factors associated with their occurrence were analyzed. Finally, survival was analyzed, the primary outcome being overall cohort mortality and stratified high cardiovascular risk mortality.

Results: Cumulative 7-day mortality was 3.68% (95% CI 2.40-4.95%) and 30-day mortality was 10.08% (95% CI 8.05-12.12%). Perioperative mortality in the high cardiovascular risk group in the first 7 days was 3.60% (95% CI 1.13-6.07%) and 14.86% (95% CI 10.15-19.58%) at 30 days. The following preoperative variables were associated with mortality: chronic obstructive pulmonary disease, chronic kidney disease, limited functional class and abdominal aortic aneurysm. A strong association was observed between postoperative complications and a significant increase in mortality rate; the most relevant complications were cerebrovascular events and cardiogenic shock.

Conclusions: In this group of high perioperative risk patients,  and in the subgroup of high cardiovascular risk patients, overall mortality at 7 and at 30 days was estimated to be above values reported in various countries. Mortality was significantly increased by the presence of preoperative factors and postoperative complications.

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How to Cite
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González Cárdenas VH, Jáuregui Romero IM, Mena Méndez Y, Silva Enríquez PN, Soler Sandoval A. Factors associated with posoperative mortality in high perioperative risk patients. Cohort study. Colomb. J. Anesthesiol. [Internet]. 2022Jun.28 [cited 2022Aug.14];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1045

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Published
2022-06-28
How to Cite
1.
González Cárdenas VH, Jáuregui Romero IM, Mena Méndez Y, Silva Enríquez PN, Soler Sandoval A. Factors associated with posoperative mortality in high perioperative risk patients. Cohort study. Colomb. J. Anesthesiol. [Internet]. 2022Jun.28 [cited 2022Aug.14];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1045
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