Key Points
- To determine the incidence, organ-system patterns, and intraoperative predictors of postoperative complications and prolonged hospitalization in patients undergoing routine, moderate-risk elective surgery.
- Prospective, blinded cohort study enrolling 438 patients undergoing diverse routine, moderate-risk elective surgical procedures.
- Postoperative complications were evaluated using a 9-point postoperative morbidity survey, with primary outcomes defined as in-hospital death or prolonged hospitalization (>7 days).
- Postoperative complications occurred in 27% of patients (n=118; 95% CI, 23–31%), while the overall in-hospital mortality rate was 1.6%.
- The most common complications involved the gastrointestinal (51% [95% CI, 42–60%]), pulmonary (25% [95% CI, 17–33%]), renal (21% [95% CI, 14–28%]), and infectious (13% [95% CI, 7–19%]) systems, mostly distant from the surgical site.
- Key intraoperative predictors of complications included indicators of tissue trauma (blood loss, P < 0.001; surgical duration, P = 0.001) and impaired tissue perfusion (arterial base deficit, P = 0.008; gastric pHi, P = 0.02).
Structured PICO
PPopulation438 patients undergoing a diverse group of routine, moderate-risk, elective surgical procedures
IInterventionPostoperative morbidity survey (9-point survey)
OOutcomePostoperative complication, defined as either in-hospital death or prolonged postoperative hospitalization (>7 days)composite
Complications after routine, moderate-risk, elective surgery are common (27%) and can be characterized using a 9-point postoperative morbidity survey.