Unplanned surgical reoperations in a tertiary hospital: perioperative mortality and associated risk factors.

摘要

BACKGROUND AND OBJECTIVES: The aim of the study was to estimate the rate of unplanned surgical reoperations in a tertiary hospital and the mortality in reoperated patients and to determine factors associated with risk of mortality in these patients. METHODS: Unplanned surgical reoperations in our hospital were recorded from 1 May 2006 to 31 March 2008. Unplanned reoperation was defined as any surgical procedure required to treat a complication of a prior procedure within the first 30 days of the initial operation. Patients were followed until hospital discharge. RESULTS: Of 11,468 patients who underwent surgery, 381 (3.3%) required reoperation. The main indications for the second or subsequent procedure were postsurgical bleeding (26.3%) and infection (31.2%). Mortality was higher in reoperated patients (21.7 vs. 2.9% in nonreoperated patients, P<0.05). Age, number of reoperations, reoperation of patients before discharge from the postoperative care unit, acute abdomen as the indication for reoperation and reoperation in the thoracic cavity were independently associated with mortality. CONCLUSION: Unplanned reoperations have important implications for patient outcomes and are related to high mortality. Certain patient-related and procedure-related factors increase risk.