Long-term disease interactions amongst surgical patients: a population cohort study
Authors' conclusion
One in eight patients undergoing surgery have multi-morbidity, accounting for more than half of all postoperative deaths.
Study context
- Population
- Adults undergoing non-obstetric surgery in the English NHS, January 2010–December 2015
- Participants
- 20,193,659 procedure spells
- Exposure
- Multi-morbidity vs no multi-morbidity
- Multi-morbidityn = 2,577,049
- No multi-morbidityn = 17,616,610reference
- Outcome
- Postoperative death
- Follow-up
- 90 days
Methodological detailsage- and sex-adjusted logistic regression, national administrative data
- Age- and sex-adjusted logistic regression
- National administrative data
Main finding
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Multi-morbidity | No multi-morbidity | OR (95% CI) | |
|---|---|---|---|---|
| 90-day death, elective spellsAge- and sex-adjusted | 2.7% | — not stated in the abstract | 4.9 (4.9–4.9) | |
| 90-day death, non-elective spellsAge- and sex-adjusted | 20.5% | — not stated in the abstract | 3.0 (3.0–3.1) | |
| 0.20.5125Odds ratio (log scale) |
— not stated in the abstract
Emergency readmission within 90 days
- 90-day death, elective spells: multi-morbidity in 1 902 859/16 946 808 (11.2%) elective spells
- 90-day death, non-elective spells: multi-morbidity in 674 190/3 246 851 (20.7%) non-elective spells
Share of all deaths in multi-morbid patients
- Elective spells: 57 663/114 783 deaths
- 50.2%
- Non-elective spells: 138 302/244 711 deaths
- 56.5%
Death by disease pair
- Death rate varied five-fold from lowest to highest risk disease pairs
Original publication
Long-term disease interactions amongst surgical patients: a population cohort study. Br J Anaesth. Published 1 July 2023. doi:10.
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