Postoperative mortality after inpatient surgery: Incidence and risk factors
Postoperative mortality after inpatient surgery: Incidence and risk factors
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住院手术后的术后死亡率：发生率和危险因素
DOI：
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发表时间：
2008
影响因子：
2.8
通讯作者：
E. Norfleet
中科院分区：
文献类型：
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作者：
K. Fecho;A. Lunney;P. Boysen;P. Rock;E. Norfleet
目的：本研究确定住院手术后48小时(h)和30天(d)死亡率的发生率并确定危险因素。方法：以麻醉学质量指标数据库为主要数据来源，进行回顾性队列研究。在数据库中查询与手术程序、麻醉护理、围手术期不良事件、出生/死亡/手术日期相关的数据。计算术后48 h和30 d的累计死亡率，并采用卡方或Fisher精确检验和广义估计方程对数据进行分析。结果：术后48 h和30 d死亡率分别为0.57%和2.1%。较高的美国麻醉医师协会身体状况评分、极端年龄、紧急情况、围手术期不良事件和术后重症监护病房入住被确定为危险因素。使用监控麻醉护理或全麻与局部麻醉或联合麻醉仅是术后30天死亡率的危险因素。麻醉护理时间、围手术期低温、外伤、故意低血压以及通过动脉、肺动脉或心血管导管进行有创监测均未被确定为危险因素。结论：我们的研究结果可用于跟踪术后死亡率，并在我们机构和其他地方测试预防性干预措施。
Purpose: This study determined the incidence of and identified risk factors for 48 hour (h) and 30 day (d) postoperative mortality after inpatient operations. Methods: A retrospective cohort study was conducted using Anesthesiology’s Quality Indicator database as the main data source. The database was queried for data related to the surgical procedure, anesthetic care, perioperative adverse events, and birth/death/operation dates. The 48 h and 30 d cumulative incidence of postoperative mortality was calculated and data were analyzed using Chi-square or Fisher’s exact test and generalized estimating equations. Results: The 48 h and 30 d incidence of postoperative mortality was 0.57% and 2.1%, respectively. Higher American Society of Anesthesiologists physical status scores, extremes of age, emergencies, perioperative adverse events and postoperative Intensive Care Unit admission were identified as risk factors. The use of monitored anesthesia care or general anesthesia versus regional or combined anesthesia was a risk factor for 30 d postoperative mortality only. Time under anesthesia care, perioperative hypothermia, trauma, deliberate hypotension and invasive monitoring via arterial, pulmonary artery or cardiovascular catheters were not identified as risk factors. Conclusions: Our findings can be used to track postoperative mortality rates and to test preventative interventions at our institution and elsewhere.