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Operative mortality in general surgery

A G Greenburg, R P Saik, J M Farris

    American Journal of Surgery
    |July 1, 1982
    PubMed
    Summary
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    This study analyzed operative mortality in over 7,000 patients, finding sepsis and advanced age are key risk factors. Despite these challenges, excellent outcomes are achievable with aggressive care and resident training.

    Area of Science:

    • Surgical Outcomes Research
    • Geriatric Surgery
    • Critical Care Medicine

    Background:

    • Operative mortality is a critical metric in surgical patient care.
    • Understanding risk factors is essential for improving surgical outcomes.
    • Veterans Administration Medical Centers serve a unique patient population.

    Purpose of the Study:

    • To define operative mortality in over 7,000 consecutive cases at a Veterans Administration Medical Center.
    • To identify factors associated with increased operative mortality.
    • To evaluate the impact of resident training and aggressive care on outcomes.

    Main Methods:

    • Retrospective analysis of over 7,000 consecutive surgical cases.
    • Identification and analysis of patient demographics, comorbidities, and procedure types.

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  • Correlation of mortality with factors such as age, preexisting disease, and sepsis.

    • Main Results:

    • Low mortality in elective procedures, often linked to malignant disease.
    • Older patients and those with preexisting conditions (pulmonary, cardiac, hepatic, malignant) face higher operative mortality.
    • Sepsis is the primary cause of death in both elective and emergency procedures.

    Conclusions:

    • Age and preexisting conditions are significant predictors of operative mortality.
    • Sepsis remains a major challenge in surgical patient care.
    • Commitment to resident training and aggressive diagnostic/therapeutic strategies, including intensive care, can lead to excellent operative mortality results.