Impact of perioperative organ injury on morbidity and mortality in 28 million surgical patients

Fig. 1. Incidence and mortality of perioperative organ injury. Perioperative organ injuries included delirium, stroke, acute myocardial infarction (AMI), acute respiratory distress syndrome (ARDS), pulmonary embolism (PE), liver injury (LI), and acute kidney injury (AKI). Each organ injury is separated into its impact as an individual organ (left panel side) or as concomitant with additional other organ injuries (right panel side). For example, AKI has a mortality rate of 20.3% when it occurs as an isolated organ injury (left panel side). However, if it happens in conjunction with another organ injury, AKI-associated mortality increases to 37.7% (right panel side). Note: among all the organ injuries investigated, AKI was the most common, while Acute Liver Injury was associated with the highest mortality.

Fig. 2. Impact of multiple perioperative organ injuries on surgical mortality and morbidity. A The mortality rate for patients with no organ injury, 1 or 2, or 3 or more were 0.7%, 13.9%, 31.0%, and 43.7%, respectively (chi-squared test, p < 0.001; error bars: 95%CI). B Kaplan–Meier survival curves show the probability of 30-day in-hospital survival for patients with different numbers of organ injuries (log-rank test, P < 0.001). C The hospital length of stay (HLOS) for patients with no organ injury, 1, 2, or 3 or more organ injuries were 4, 16, 24, and 29 days, respectively (Median test, P < 0.001, median and quartiles). D Kaplan–Meier hazard curves show the probability of 30-day hospital discharge for patients with different numbers of organ injuries (log-rank test, P < 0.001). Among all patients, 3.7% (n = 1,042,713) experienced one organ injury, 0.6% (n = 173,959) experienced two organ injuries, and 0.1% (n = 29,491) experienced three or more organ injuries perioperatively.