Managing perioperative risk in patients undergoing elective non-cardiac surgery - BMJ review

Non-cardiac surgery has a low overall mortality but is associated with a large number of deaths because so many procedures are performed (250 million major surgical procedures worldwide per year).

Assuming a hospital mortality rate of 1%, non-cardiac surgery will be associated with 2.5 million deaths worldwide each year and complication rates at least five times this figure.

15% of people who undergo inpatient surgery are at high risk of complications, such as pneumonia or myocardial infarction.

Most deaths occur in a group of patients who are at high risk because of:

- advanced age
- comorbid disease
- major surgery

High risk surgical patients account for 80% of all perioperative deaths.

Further research is needed to identify the most effective approaches to perioperative medicine for high risk patients.

References:

Managing perioperative risk in patients undergoing elective non-cardiac surgery. BMJ 2011; 343 doi: 10.1136/bmj.d5759 (Published 5 October 2011), Cite this as: BMJ 2011;343:d5759

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