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  • Title: [Mortality-associated factors in major surgery: retrospective analysis in a referral center].
    Author: Medina-Franco H, Ramos-de la Medina A, Torres-Villalobos G, de León HT.
    Journal: Rev Invest Clin; 2006; 58(1):9-14. PubMed ID: 16789595.
    Abstract:
    BACKGROUND: There are very few studies that analyze surgical morbidity and mortality in the general population and the factors associated with those events. OBJECTIVE: To determine factors associated to mortality in surgical procedures performed in a tertiary referral center in Mexico City. METHODS: We retrospectively analyze surgical mortality in 4,157 consecutive surgical procedures performed in a one-year period from 1/1/2000 through 12/31/2000. Categorical variables were analyzed with the chi-square test and continuous variables with the t-Student test. Significance was defined as p < 0.05. RESULTS: During the study period there were 76 postoperative deaths, representing a mortality rate of 1.82%. Mean patient's age in the entire cohort was 48.7 +/- 17.6 years and for the patients who died in the postoperative period 57.8 +/- 17.8 years (p < 0.05). Sixty-six percent of deaths were attributed to the primary or surgical disease. In 33.8% of postoperative deaths an adverse event was identified as responsible for the outcome. In 23% of cases there was a potentially preventable event, representing 0.3% of surgical procedures. Most patients (96.9%) had at least one comorbid condition and 61.5% had two or more. Almost 80% of surgical deaths occurred in patients with ASA score III of IV and albumin levels below 3.5 g/dL. Most common cause of death was sepsis, reported in 35% of patients who died in the postoperative period. CONCLUSION: Surgical mortality in our series is low. In 0.3% of procedures it was detected a potentially preventable event. Postoperative deaths occurred in older patients with low albumin levels.
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