High-risk surgery: epidemiology and outcomes.
Suneetha Ramani Moonesinghe1, Michael Gerard Mythen, Michael Patrick William Grocott
1Centre for Anaesthesia, University College London Hospital, 235 Euston Rd., London, UK. rmoonesinghe@gmail.com
Anesthesia and Analgesia
|May 25, 2010
Summary
Surgical morbidity affects millions globally, impacting long-term survival. This review explores healthcare delivery and patient factors influencing surgical outcomes and proposes improved risk assessment tools.
Area of Science:
- Surgical outcomes research
- Public health
- Healthcare quality improvement
Background:
- Surgical morbidity and mortality represent a significant global public health concern, affecting millions of patients annually.
- Perioperative complications are linked to reduced long-term survival, highlighting the importance of understanding surgical outcomes.
- Variations in healthcare delivery and patient-specific factors contribute to disparities in surgical morbidity and mortality.
Purpose of the Study:
- To review factors influencing surgical outcomes, including healthcare delivery and patient-related elements.
- To evaluate methods for assessing perioperative risk and surgical outcomes.
- To identify future research directions for enhancing surgical care quality.
Main Methods:
- Literature review examining factors affecting surgical outcomes.
- Analysis of healthcare delivery aspects (structure, process, resource utilization).
- Evaluation of patient-related factors (comorbidities, functional capacity, cardiovascular health) and assessment tools (risk stratification, exercise testing, biomarkers).
Main Results:
- Healthcare delivery variations impact surgical morbidity and mortality.
- Patient factors like comorbidities and functional status are critical determinants of perioperative risk.
- Current risk stratification and outcome assessment tools have limitations.
Conclusions:
- Improving precision in perioperative risk assessment tools is crucial.
- Enhanced outcome measures are needed to evaluate surgical healthcare quality.
- Future work should focus on developing better tools for clinical trials, epidemiological studies, and quality improvement programs.
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