Perioperative medicine & outcomes
Impaired tissue perfusion in high-risk patients having major abdominal surgery: a multicenter observational study
Authors' conclusion
Approximately 60% of high-risk patients undergoing major abdominal surgery demonstrated postoperative signs of impaired tissue perfusion, although most patients exhibited only one sign.
Study context
- Population
- High-risk patients undergoing major abdominal surgery at 5 university hospitals in Germany
- Participants
- 291 patients
- Outcome
- Proportion of patients with signs of impaired tissue perfusion (capillary refill time ≥ 3 s, mottling score ≥ 1, lactate ≥ 2 mmol/L, or central venous oxygen saturation ≤ 65%)
- Follow-up
- Until the first POD
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
- Any sign of impaired tissue perfusion at any postoperative time point
- 171 patients (59%)
- Prolonged capillary refill time
- 19 patients (7%)
- Elevated mottling score
- 43 patients (15%)
- Elevated lactate
- 73 patients (25%)
- Low central venous oxygen saturation
- 119 patients (41%)
Observational data: associations, not effects.
Further findings
Macrocirculation variables, patients with vs without signs of impaired tissue perfusion
- No meaningful differences
Association of any postoperative sign of impaired tissue perfusion with outcomes
- Weakly associated with longer ICU LOS
- P = 0.012
- Not meaningfully associated with highest SOFA score on POD 1, 3 or 5, hospital LOS, or 28-day mortality
Original publication
Impaired tissue perfusion in high-risk patients having major abdominal surgery: a multicenter observational study. Crit Care. Published 11 March 2026. doi:10.
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