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Association between complications and mortality after cardiac surgery: Results from the Vascular Events in Surgery

André Lamy1, Austin Browne1, Richard P Whitlock1

  • 1Department of Perioperative Medicine, Population Health Research Institute, Hamilton, Ontario, Canada.

The Journal of Thoracic and Cardiovascular Surgery
|May 30, 2026
PubMed

Insights

Acute kidney injury is linked to about one-third of cardiac surgery deaths. Preventing acute kidney injury, infections, and bleeding can significantly reduce patient mortality after cardiac surgery.

Area of Science:

  • Cardiology and Cardiac Surgery
  • Critical Care Medicine
  • Nephrology

Background:

  • Identifying key complications after cardiac surgery is crucial for improving patient outcomes.
  • The prognostic impact of specific postoperative complications on mortality remains an area requiring further investigation.

Purpose of the Study:

  • To assess the association between postoperative complications and mortality at 30 days and 1 year post-cardiac surgery.
  • To rank complications based on their contribution to mortality after cardiac surgery.

Main Methods:

  • Analysis of 15,550 patients from the prospective VISION Cardiac Surgery cohort study.
  • Calculation of Population Attributable Fractions (PAFs) to quantify the proportion of deaths linked to each complication.
  • Primary outcome: all-cause mortality at 30 days and 1 year.

Main Results:

  • Acute kidney injury (AKI) had the largest Population Attributable Fraction (PAF) for 30-day mortality (37%).
  • Other significant complications included bleeding (12% PAF), infection (12% PAF), and myocardial injury after cardiac surgery (10% PAF).
  • Overall 1-year mortality was 5.5% (859 deaths).

Conclusions:

  • Acute kidney injury is associated with approximately one-third of all deaths following cardiac surgery.
  • Targeted prevention strategies for AKI, infections, bleeding, and myocardial injury show potential for reducing mortality in cardiac surgery patients.
Abstract

Keywords:
acute kidney injurycardiac surgeryinfectionmortalitymyocardial injurypopulation attributable fractionpostoperative complication

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