Structure and frequency of comorbidities and associated postoperative complications: a national observational multicenter study STOPRISK-Reference-Cited by-同舟云学术

Structure and frequency of comorbidities and associated postoperative complications: a national observational multicenter study STOPRISK

Published:2023-07-28 Issue:3 Volume: Page:43-57
ISSN:1818-474X
Container-title:Annals of Critical Care
language:
Short-container-title:Annals of Critical Care

Author:

Zabolotskikh Igor B.¹^ORCID,Trembach N. V.²^ORCID,Magomedov M. A.³^ORCID,Popov A. S.⁴^ORCID,Malyshev Yu. P.⁵^ORCID,Dmitriev A. A.⁶^ORCID,Grigoryev E. V.⁷^ORCID,Fisher V. V.⁸^ORCID,Khoronenko V. E.⁹^ORCID,Kokhno V. N.¹⁰^ORCID,Spasova A. P.¹¹^ORCID,Davydova V. R.¹²^ORCID,Gritsan A. I.¹³^ORCID,Lebedinskii K. M.¹⁴^ORCID,Dunts P. V.¹⁵^ORCID,Bayalieva A. Zh.¹⁶^ORCID,Ovezov A. M.¹⁷^ORCID,Martynov D. V.¹⁸^ORCID,Arikan N. G.¹⁹^ORCID,Kirov M. Yu.²⁰^ORCID,Ershov V. I.²¹^ORCID,Pasechnik I. N.²²^ORCID,Kuzovlev A. N.²³^ORCID,Fedunets D. E.⁶^ORCID

Affiliation:

1. Kuban State Medical University, Krasnodar, Russia; Regional Clinical Hospital No 2, Krasnodar, Russia; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia

2. Kuban State Medical University, Krasnodar, Russia; Regional Clinical Hospital No 2, Krasnodar, Russia

3. City Clinical Hospital No 1 named after N.I. Pirogov, Moscow, Russia; Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

4. Volgograd State Medical University, Volgograd, Russia

5. Kuban State Medical University, Krasnodar, Russia; S.V. Ochapovskiy Research Institute Regional clinical hospital No 1, Krasnodar, Russia

6. Kuban State Medical University, Krasnodar, Russia

7. Research Institute of Complex Problems of Cardiovascular Diseases, Kemerovo, Russia

8. Stavropol Regional Clinical Hospital, Stavropol, Russia; Stavropol State Medical University, Stavropol, Russia

9. P.A. Hertsen Moscow Oncology Research Center, Moscow, Russia

10. State Novosibirsk Regional Clinical Hospital, Novosibirsk, Russia

11. Republican hospital named after V.A. Baranov, Petrozavodsk, Russia

12. Kazan State Medical University, Kazan, Russia

13. Regional Clinical Hospital, Krasnoyarsk, Russia; Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky, Krasnoyarsk, Russia

14. Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia; North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia

15. Regional Clinical Hospital No. 2, Vladivostok, Russia

16. Republican Clinical Hospital, Kazan, Russia

17. Moscow Regional Research and Clinical Institute, Moscow, Russia

18. Rostov State Medical University, Rostov-on-Don, Russia

19. F.I. Inozemtsev City Clinical Hospital, Moscow, Russia

20. Northern State Medical University, Arkhangelsk, Russia; First City Clinical Hospital named after E.E. Volosevich, Arkhangelsk, Russia

21. Orenburg Regional Clinical Hospital, Orenburg, Russia

22. Joint Hospital with Polyclinic of the Office of the President of the Russian Federation, Moscow, Russia

23. Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia

Abstract

INTRODUCTION: Risk assessment and identification of a group of patients with a high probability of developing an unfavorable outcome is the basis for effective prevention of postoperative adverse events. OBJECTIVE: The purpose of the study was to determine the structure and frequency of co-existing diseases in the preoperative period and associated adverse postoperative outcomes. MATERIALS AND METHODS: The analysis of the parameters of 8,241 patients of the STOPRISK database operated on abdominal and pelvic organs for the period from July 1, 2019 to April 30, 2022 was carried out. RESULTS: Co-existing diseases occurred in 4,638 patients (56.3 %), while one disease was observed in 1,872 patients (22.7 %), a combination of two diseases — in 1,383 patients (16.8 %), three diseases — in 814 patients (9.9 %), four diseases — in 395 patients (4.8 %), and more than 4 — in 170 patients (2.0 %). The most common were arterial hypertension — 48.2 %, chronic heart failure (20.7 %), coronary heart disease (19.3 %). The presence of one or more complications was recorded in 285 patients (3.5 %), fatal outcome — in 36 patients (0.43 %). 74.0 % of patients had a single complication, 14.0 % had a combination of two complications, and 12.0 % had a combination of three or more complications. The structure of complications was dominated by paralytic ileus (25.57 %), pneumonia (12.1 %), wound infection (12.1 %). Both mortality and the frequency of complications increased with an increase in the number of co-existing diseases. CONCLUSIONS: The most common co-existing diseases in abdominal surgery are arterial hypertension, chronic heart failure, coronary heart disease, diabetes mellitus and cardiac arrhythmia. The frequency of postoperative complications was 3.5 %, mortality was 0.43 %; the most frequent complications were paralytic ileus, wound infection and pneumonia.

Publisher

Practical Medicine Publishing House

Subject

Law,Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine,Emergency Medical Services

Reference27 articles.

1. Kim M., Wall M.M., Li G. Risk stratification for major postoperative complications in patients undergoing intra-abdominal general surgery using latent class analysis. Anesth. Analg. 2018; 126: 848–57. DOI: 10.1213/ANE.0000000000002345

2. Khuri S.F., Henderson W.G., DePalma R.G., et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg. 2005; 242(3): 326–43. DOI:10.1097/01.sla.0000179621.33268.83

3. Козлов И.А., Овезов А.М., Петровская Э.Л. Периоперационные повреждение миокарда и сердечная недостаточность в некардиальной хирургии (обзор). Часть 1. Этиопатогенез и прогнозирование периоперационных кардиальных осложнений. Общая реаниматология. 2019; 15(2): 53–78 . DOI: 10.15360/1813-9779-2019-2-53-78 [Kozlov I.A,. Ovezov A.M., Petrovskaya E.L. Perioperative myocardial damage and heart failure in noncardiac surgery. Part 1. Etiopathogenesis and prognosis of perioperative cardiac complications (Review) General reanimatology. 2019; 15(2): 53–78. DOI: 10.15360/1813-9779-2019-2-53-78 (In Russ)]

4. Reilly J.R., Gabbe B.J., Brown W.A., et al. Systematic review of perioperative mortality risk prediction models for adults undergoing inpatient non-cardiac surgery. ANZ J Surg. 2021; 91(5): 860–70. DOI: 10.1111/ans.16255

5. Заболотских И.Б., Трембач Н.В., Магомедов М.А. и др. Сравнительная оценка шкал прогнозирования неблагоприятного послеоперационного исхода: Предварительные результаты МЦИ «Роль сопутствующих заболеваний в стратификации риска послеоперационных осложнений в абдоминальной хирургии STOPRISK». Вестник интенсивной терапии им. А.И. Салтанова. 2022; 3: 27–44. DOI: 10.21320/1818-474X-2022-3-27-44 [Zabolotskikh I.B., Trembach N.V., Magomedov M.A., et al. Comparative evaluation of scales for predicting an unfavorable postoperative outcome: Preliminary results of the multicenter study “The role of concomitant diseases in the stratification of the risk of postoperative complications in abdominal surgery STOPRISK”. Annals of Critical Care. 2022; 3: 27–44. DOI: 21320/1818-474X-2022-3-27-44 (In Russ)]