The long-term effects of postoperative complications

Area of Science:

• Perioperative Medicine
• Surgical Outcomes Research

Background:

• Postoperative complications are known to impact short-term patient outcomes.
• The long-term survival implications of these complications require further elucidation.

Purpose of the Study:

• To review the long-term influence of postoperative complications on patient survival.
• To explore the extent and reasons for a potential longer-term relationship between complications and mortality.

Main Methods:

• Systematic review of existing literature, focusing on studies examining postoperative complications and long-term survival.
• Analysis of large multicentre studies and smaller cohorts, particularly in cancer surgery.

Main Results:

• Large multicentre analyses consistently show an association between postoperative complications and increased long-term mortality.
• While confounding factors and short-term outcome separation may play a role, functional and biological imprints from complications are likely significant.
• Results in smaller cohorts have been mixed, highlighting the need for robust data.

Conclusions:

• Patients who experience postoperative complications and survive the acute phase exhibit worsened long-term mortality.
• Perioperative medicine must focus on identifying at-risk patients, preventing/treating complications, and optimizing post-discharge care pathways.