Perioperative medicine & outcomes
Temporal trends in postoperative outcomes after major abdominal surgery: a population-based cohort study
Authors' conclusion
Despite advances in perioperative protocols and techniques, the overall adjusted rate of moderate-to-severe complications did not change over time. Contrasting trends were evident between different surgical procedures.
Study context
- Population
- Adults undergoing major elective abdominal surgery (gastroesophagectomy, pancreaticoduodenectomy, partial hepatectomy, colorectal resection), Ontario, Canada, 2005–21
- Participants
- 148,725 adults
- Exposure
- Temporal trends over 2005-21
- Outcome
- Composite of moderate-to-severe postoperative complications
Methodological detailscase-mix adjusted linear trends
- Case-mix adjusted linear trends
Main finding
As reported in the abstract
Yearly rate of moderate-to-severe complications
Yearly rate of moderate-to-severe complications similar over time, RR
0.994
95% CI 0.985–1.002
Observational data: associations, not effects.
Secondary outcomes
Health system outcomes (yearly trend)
- LOS, RR
- 0.968 (95% CI 0.959-0.977)
- ICU admission, RR
- 0.982 (95% CI 0.966-0.998)
- Days alive and at home, RR
- 1.004 (95% CI 1.003-1.005)
- Total costs, RR
- 0.990 (95% CI 0.982-0.997)
- Temporal improvements
Complication rates by procedure (subgroup, yearly trend)
- Colorectal resection, RR (95% CI 0.980-0.997), improved
- 0.988
- Gastroesophagectomy, RR (95% CI 0.974-0.996), improved
- 0.985
- Partial hepatectomy, RR (95% CI 1.003-1.022), increased
- 1.012
- Pancreaticoduodenectomy, RR (95% CI 1.004-1.028), increased
- 1.016
Original publication
Temporal trends in postoperative outcomes after major abdominal surgery: a population-based cohort study. Br J Anaesth. Published 23 October 2025. doi:10.
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