Structure and frequency of comorbidities and associated postoperative complications: a national observational multicenter study STOPRISK

Abstract

INTRODUCTION: Risk assessment and identification of a group of patients with a high probability of developing an unfavorable outcome is the basis for effective prevention of postoperative adverse events. OBJECTIVE: The purpose of the study was to determine the structure and frequency of co-existing diseases in the preoperative period and associated adverse postoperative outcomes. MATERIALS AND METHODS: The analysis of the parameters of 8,241 patients of the STOPRISK database operated on abdominal and pelvic organs for the period from July 1, 2019 to April 30, 2022 was carried out. RESULTS: Co-existing diseases occurred in 4,638 patients (56.3 %), while one disease was observed in 1,872 patients (22.7 %), a combination of two diseases — in 1,383 patients (16.8 %), three diseases — in 814 patients (9.9 %), four diseases — in 395 patients (4.8 %), and more than 4 — in 170 patients (2.0 %). The most common were arterial hypertension — 48.2 %, chronic heart failure (20.7 %), coronary heart disease (19.3 %). The presence of one or more complications was recorded in 285 patients (3.5 %), fatal outcome — in 36 patients (0.43 %). 74.0 % of patients had a single complication, 14.0 % had a combination of two complications, and 12.0 % had a combination of three or more complications. The structure of complications was dominated by paralytic ileus (25.57 %), pneumonia (12.1 %), wound infection (12.1 %). Both mortality and the frequency of complications increased with an increase in the number of co-existing diseases. CONCLUSIONS: The most common co-existing diseases in abdominal surgery are arterial hypertension, chronic heart failure, coronary heart disease, diabetes mellitus and cardiac arrhythmia. The frequency of postoperative complications was 3.5 %, mortality was 0.43 %; the most frequent complications were paralytic ileus, wound infection and pneumonia.