geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Complication timing and association with mortality in the American College of Surgeons' National Surgical Quality Improvement Program database


, : Complication timing and association with mortality in the American College of Surgeons' National Surgical Quality Improvement Program database. Journal of Surgical Research 193(1): 77-87

The relationship between timing of postoperative complications on mortality is unknown. We investigated the time-variable mortality risks of common surgical complications. We identified patients undergoing nonemergent, in-patient surgery in the National Surgical Quality Improvement Program (NSQIP) database during 2005-2011 who experienced any of 13 complications within 2 wk of surgery. "Expected timing" was defined as the median postoperative day of occurrence. Hazard ratios (HRs) for complications earlier or later than expected were calculated using Cox proportional hazards, adjusted for age, procedure, American Society of Anesthesiology (ASA), and functional status. A secondary analysis evaluated the effect of preceding complication burden on the relationship between complication timing and mortality. Among 77,443 patients experiencing complications, significantly higher mortality was observed with early wound infections (superficial HR 1.30, confidence interval [CI] 1.01-1.70; deep HR 1.52, CI 1.07-2.16; and organ space HR 1.38, CI 1.11-1.70) despite adjustment for patient and operative factors and complication burden. Early cardiac arrest and unplanned intubation were associated with lower mortality, which persisted after adjustment (HR 0.59, CI 0.51-0.68; HR 0.38, CI 0.33-0.43, respectively). By contrast, late occurrence of acute myocardial infarction, pneumonia, and cerebrovascular accident was associated with significantly greater mortality risk (HR 1.41, CI 1.18-1.69; HR 1.37, CI 1.24-1.52; and HR 1.61, CI 1.31-1.98, respectively), but these associations became nonsignificant after adjustment for complication burden. Timing of complications plays an important role in mortality. Surgeons and trainees should be aware of these patterns and tailor their clinical care and monitoring practices to account for the implications of complication timing on mortality.

US$19.90

PMID: 25260955

DOI: 10.1016/j.jss.2014.08.025


Other references

Volynets, Ap, 1970: Application of herbicides in stands of regional varieties of fiber flax. Goncharik M N Nauka v bor'be za urozhai: 3-47

Bolli, J., C.; Rigling, A.; Bugmann, H., 2007: The influence of changes in climate and land-use on regeneration dynamics of Norway spruce at the treeline in the swiss Alps. Recent changes of climate and land-use are often regarded to affect the European Alpine region substantially and to trigger an increase in the elevation of the upper treeline. The patterns of tree invasion on a subalpine meadow at 1900 in a.s.l....

Orlov V.S., 1988: To the theory of pinocytosis factors determining the dynamics of pinocytosis in capillary endothelium. Peculiarities of the mechanism and conditions of pinocytosis vesicules formation in capillary endothelium are considered in relation to: 1) the size of a protein cluster which is formed from plasma proteins on the endotheliocyte plasma membrane su...

Ko, J-A.; Ryu, Y.Bae.; Park, T-Soon.; Jeong, H.Jae.; Kim, J-Hoon.; Park, S-Jin.; Kim, J-Su.; Kim, D.; Kim, Y-Min.; Lee, W.Song., 2013: Enzymatic synthesis of puerarin glucosides using Leuconostoc dextransucrase. Puerarin (P), an isoflavone derived from kudzu roots, has strong biological activities, but its bioavailability is often limited by its low water solubility. To increase its solubility, P was glucosylated by three dextransucrases from Leuconostoc...

Giunchi, G., 1966: Evaluation of antibiotic activity. Clinical evaluation of data obtained in vitro from antibiograms. Antibiotica 4(3): 149-168

Airapetyan M.K., 1966: Neopl tumors of the carotid body human. Zhurnal Eksperimental'noi i Klinicheskoi Meditsiny 6(3): 31-37

Sipavichu T.Butnevichenie, A.A., 1962: The rearing of young beef cattle on below-normal whole milk rations. Previous experiments by a number of other investigators had demonstrated the possibility of obtaining excellent weight gains in beef calves when a part of the usual whole milk ration was replaced by a substitute food containing adequate quantities...

Marx, J.L., 1978: Killer bees: o death, where is thy sting?. The U.S. Geological Survey recently completed an intensive river quality assessment study of the Willamette River basin, Oregon. The most noteworthy finding was that across-the-board advanced waste treatment was not the answer to the problem of me...

Kimura, J.; Maki, N., 2002: New loliolide derivatives from the brown alga Undaria pinnatifida. Seven carotenoid metabolites including five loliolide derivatives have been isolated from the brown alga Undaria pinnatifida, including three new compounds. Structures of these compounds were confirmed by spectroscopic analyses and literature data...

Smart, J.L.; Jeffery, C.; Richards, B., 1980: A retrospective study of the relationship between birth history and handedness at six years. Bakan's hypothesis that sinistrality is caused by perinatal insult was investigated by attempting to relate the handedness of 1094 six-year-old children to many aspects of their birth history ascertained from hospital records. Handedness of t...