[Perioperative risk and mortality after major surgery].

Area of Science:

• Perioperative Medicine
• Surgical Outcomes
• Patient Safety

Context:

• Despite reduced anesthesia mortality, perioperative mortality remains high (0.8-4%), influenced by patient comorbidities and slow-onset complications like infections.
• Failure to rescue (FTR), the rate of death from complications, varies significantly between hospitals, indicating a potential area for quality improvement.
• An estimated 60,000 preventable deaths occur annually in Germany due to high FTR rates.

Purpose:

• To highlight the significance of failure to rescue (FTR) as a key indicator of perioperative care quality.
• To emphasize the need for improved strategies in identifying at-risk patients and managing postoperative complications.
• To underscore the potential for reducing perioperative mortality through enhanced monitoring and timely treatment.

Summary:

• Perioperative mortality is significantly impacted by patient comorbidities and slow-onset complications, such as infections.
• Failure to rescue (FTR) is a critical metric for assessing perioperative care quality, with substantial room for improvement.
• Effective strategies include early risk identification, complication prevention, robust surveillance, and prompt treatment of postoperative issues.

Impact:

• Reducing FTR rates can significantly decrease preventable perioperative deaths.
• Implementing improved surveillance and treatment protocols can enhance patient outcomes and reduce healthcare costs.
• Focusing on FTR can lead to more equitable and higher-quality surgical care across different healthcare facilities.