Factores de riesgo de mortalidad de los pacientes quirúrgicos en un hospital terciario: estudio del registro de pacientes en el periodo 2004¿2006 / Mortality risk factors in surgical patients in a tertiary hospital: a study of patient records in the period 2004¿2006

Objetivo: Determinar los factores de riesgo de mortalidad de los pacientes quirúrgicos. Material y métodos: Se incluyó a todos los pacientes operados que fallecieron en el curso del procedimiento peroperatorio en el periodo 2004¿2006. Se realizó un estudio de corte transversal. Se analizaron variables preoperatorias, intraoperatorias y postoperatorias. Se han analizado los factores de riesgo de muerte en los pacientes intervenidos de urgencia y en los intervenidos electivamente. Se ha realizado un análisis multivariable correlacionando las diferentes variables mediante la prueba de la χ2 de Pearson con un intervalo de confianza del 95%. Resultados: Durante el periodo que abarca el estudio fueron intervenidos 38.815 pacientes con ingreso hospitalario: 6.326 de urgencia y 32.489 de forma electiva. Durante el ingreso hospitalario murió un total de 479 pacientes; 36 intraoperatoriamente y 443 tras la intervención quirúrgica. La hipertensión arterial, la diabetes mellitus y el diagnóstico de neoplasia tuvieron significación estadística con la muerte. Las complicaciones quirúrgicas resultaron significativas para los pacientes que fallecieron en el intraoperatorio. La cirugía de urgencia es un factor de riesgo independiente de mortalidad (5,5% de mortalidad en relación con el 0,4% para la cirugía electiva). Las complicaciones postoperatorias fueron los principales factores de riesgo de mortalidad, en especial la sepsis, los problemas cardíacos y los respiratorios. Conclusiones: La prevención y el correcto tratamiento de todos los factores de riesgo preoperatorios, intraoperatorios y postoperatorios se presume disminuirían de forma significativa los índices de mortalidad y morbilidad de los pacientes intervenidos quirúrgicamente, en especial en aquellos intervenidos de urgencia (AU)

Objective: To determine mortality risk factors in surgical patients. Material and method: A cross-sectional study was carried out on all surgical patients who died while in hospital, over a period of three years (2004¿2006). Pre, intra and postoperative variables were analysed. Comparisons were made between patients operated on as emergencies and elective surgery patients. Multivariate analysis was performed on the pre, intra and postoperative variables, using χ2 of Pearson correlation with a confidence interval of 95%. Results: Surgery was performed on a total of 38 815 patients, of which 6 326 were emergency procedures and 32 489 as elective. There were 479 deaths registered: 36 occurred in the operating theatre and 443 died after the operation. Arterial hypertension, diabetes mellitus and cancer were significant causes of death. Intraoperative complications were associated with mortality during the surgical procedure. Emergency surgery was an independent risk factor (mortality, 5.5% vs. 0.4% for elective surgery). Sepsis, cardiac and respiratory related deaths were the main risk factors for postoperative death. Conclusions: Prevention and adequate treatment of perioperative risk factors should significantly reduce morbidity and mortality rates, mainly in those patient operated as emergencies (AU)

[Mortality risk factors in surgical patients in a tertiary hospital: a study of patient records in the period 2004-2006]. / Factores de riesgo de mortalidad de los pacientes quirúrgicos en un hospital terciario: estudio del registro de pacientes en el periodo 2004-2006.

OBJECTIVE: To determine mortality risk factors in surgical patients. MATERIAL AND METHOD: A cross-sectional study was carried out on all surgical patients who died while in hospital, over a period of three years (2004-2006). Pre, intra and postoperative variables were analysed. Comparisons were made between patients operated on as emergencies and elective surgery patients. Multivariate analysis was performed on the pre, intra and postoperative variables, using chi(2) of Pearson correlation with a confidence interval of 95%. RESULTS: Surgery was performed on a total of 38 815 patients, of which 6 326 were emergency procedures and 32 489 as elective. There were 479 deaths registered: 36 occurred in the operating theatre and 443 died after the operation. Arterial hypertension, diabetes mellitus and cancer were significant causes of death. Intraoperative complications were associated with mortality during the surgical procedure. Emergency surgery was an independent risk factor (mortality, 5.5% vs. 0.4% for elective surgery). Sepsis, cardiac and respiratory related deaths were the main risk factors for postoperative death. CONCLUSIONS: Prevention and adequate treatment of perioperative risk factors should significantly reduce morbidity and mortality rates, mainly in those patient operated as emergencies.