Prospective study on long-term outcome after abdominal surgery

Acta Anaesthesiol Scand. 2018 Feb;62(2):147-158. doi: 10.1111/aas.13025. Epub 2017 Nov 1.

Abstract

Background: Complications following major abdominal surgery are common and an important cause of morbidity and mortality. The aim of this study was to describe 1-year mortality and identify factors that influence adverse outcomes after abdominal surgery.

Methods: This prospective observational cohort study was performed in Landspitali University Hospital and included all adult patients undergoing abdominal surgery requiring > 24-h hospital admission over 13 months. The follow-up period was 60 days for complications and 24 months for mortality.

Results: Data were available for 1113 (99.5%) of the 1119 patients who fulfilled inclusion criteria. A total of 23% of patients had at least one underlying co-morbidity. Non-elective surgeries were 48% and 13% of the patients were admitted to ICU post-operatively. A total of 20% of patients developed complications. Mortality at 30 days, 1 and 2 years was 1.8%, 5.6%, and 8.3% respectively. One-year mortality for those admitted to ICU was 18%. The long-term survival of the individuals surviving 30 days was significantly worse than for an age- and gender-matched population control group. Independent predictors for 1-year mortality were age, pre-operative acute kidney injury and intermediate- or major surgery.

Conclusion: Post-operative complication rates and mortality following abdominal surgery in Iceland were comparable or in the lower range of previously published outcomes, validating the utility of offering a full host of abdominal surgical services in geographically isolated region with a relatively small referral base.

Publication types

  • Observational Study

MeSH terms

  • Abdomen / surgery*
  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / mortality
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Comorbidity
  • Critical Care
  • Female
  • Follow-Up Studies
  • Humans
  • Iceland / epidemiology
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / mortality*
  • Prospective Studies
  • Registries
  • Sex Factors
  • Survival Analysis
  • Treatment Outcome