The High-Risk Surgical Patient: Current Management Strategies to Reduce Morbidity and Mortality from Organ...

A number of patients undergoing major surgery have an associated high morbidity leading to a long stay in the intensive care unit. This group of patients can be regarded as high risk, as their mortality rate is in the region of 20 to 30%. The high-risk patient is likely to have at least one of the characteristics listed in Table 1. Perioperative cardiac morbidity remains the leading cause of postoperative mortality. Although we can now support patients through the early phase of shock, trauma or other life-threatening illness, some will go on to develop progressive failure of one or more vital organs. In this article, we review some of the current processes of care that may improve outcomes in these surgical patients, as improving patient outcome is the purpose of medical care.