Perioperative medicine & outcomes
Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe
Authors' conclusion
Multimorbidity is common and outcomes are poor among surgical patients across Europe.
Study context
- Population
- Patients undergoing major abdominal surgery in 446 hospitals in 29 countries across Europe
- Participants
- 24,227 patients · 446 hospitals · 29 countries
- Exposure
- One long-term condition or multimorbidity vs ≤ 1 long-term condition
- Multimorbidityn = 10,486
- One long-term conditionn = 7,006
- Outcome
- Postoperative mortality
- Follow-up
- 30 days
Methodological detailspre-planned analysis, multicentre, international
- Pre-planned analysis
- Multicentre
- International
Main finding
As reported in the abstract
30-day postoperative mortality
Each group vs no long-term conditionAdjusted odds ratio (95% CI)
One long-term condition
1.93(1.16–3.23)
Multimorbidity
2.22(1.35–3.64)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | |
|---|---|---|
| Mediation of 30-day mortality by frailty and ASA 3-5 · 30 daysOne long-term condition vs No long-term condition · estimated 31.7% mediated | 1.30 (1.12–1.51) | |
| Mediation of 30-day mortality by frailty and ASA 3-5 · 30 daysMultimorbidity vs No long-term condition · estimated 36.9% mediated | 1.61 (1.36–1.91) | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | Multimorbidity | One long-term condition |
|---|---|---|
| Prevalence of long-term conditions | 43.9% | 28.9% |
- Prevalence of long-term conditions — Primary cancer
- 39.6%
- Prevalence of long-term conditions — Hypertension
- 37.9%
- Prevalence of long-term conditions — CKD
- 17.4%
- Prevalence of long-term conditions — DM
- 15.4%
Frailty
- Higher incidence of frailty with multimorbidity vs ≤ 1 long-term condition
30-day mortality with pre-operative medical assessment (multimorbidity)
- No improvement in 30-day mortality with pre-operative medical assessment
Original publication
Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe. Anaesthesia. Published 27 May 2024. doi:10.
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