Postoperative Outcomes Following Elective Surgery in India

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Surgical Outcomes Research

Background:

• The incidence of postoperative complications and mortality following elective surgery in India was previously unknown.
• Indian data was collected for a global study (ISOS) but excluded from primary analysis due to the limited number of participating centers.
• This study reports on the postoperative outcomes specifically within the Indian cohort.

Purpose of the Study:

• To determine the incidence of postoperative complications and mortality in patients undergoing elective surgery in India.
• To analyze factors associated with complications and their impact on patient outcomes.
• To assess the relationship between complications, critical care admission, and hospital stay duration.

Main Methods:

• A prospective, 7-day observational study was conducted.
• Data were collected for 30 days from adult patients undergoing elective surgery, with a waiver of informed consent.
• Primary outcome was in-hospital postoperative complications; secondary outcomes included mortality, critical care admission, and hospital stay duration.

Main Results:

• Complications occurred in 27.5% of patients, with higher rates in older patients and those with American Society of Anaesthesiologists (ASA) grades III and IV.
• Major surgical procedures, often for malignancy, were performed in 65.7% of patients.
• Mortality was 2.4% overall, but significantly higher (8.8%) in patients who developed complications.

Conclusions:

• Approximately 28% of patients experienced postoperative complications after elective surgery in India.
• Age and complexity of surgical procedures were independent predictors of complications.
• Lower preoperative hemoglobin showed a protective effect, and mortality was substantially increased in patients with complications.