Where Is Your Risk of Dying Greatest After Surgery?

Patients who have noncardiac surgery are much more likely to die after they leave the hospital than in the operating room, a new study finds.

Researchers analyzed data on more than 40,000 adults, age 45 and older, who were operated on at 28 centers in 14 countries in North and South America, Asia, Europe, Africa and Australia.

Of those patients, 1.8% died within 30 days of surgery. Major bleeding, injury to the heart muscle and severe infection (sepsis) accounted for 45% of the deaths.

Only 0.7% of the deaths took place in the operating room, while 29% occurred after patients left the hospital.

The study was published July 29 in the Canadian Medical Association Journal.

"Given that most deaths in adults undergoing noncardiac surgery occur not in the operating room, but afterwards, efforts to improve postsurgical care in hospital and at home has substantial potential to reduce mortality," study author Dr. P.J. Devereaux said in a journal news release. He's a senior scientist at McMaster University in Hamilton, Ontario, Canada.

"Approximately 100 million adults aged 45 or older undergo noncardiac surgery worldwide every year, therefore an estimated 1.8 million people die of complications within 30 days," Devereaux said.

"This means that death after surgery is a major global health burden," he added.

The study authors said it may be possible to prevent some of these deaths through efforts that focus on prevention, early identification and close management of bleeding, cardiac issues and infection.

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