ArticleBritish journal of anaesthesia2023
Long-term disease interactions amongst surgical patients: a population cohort study.
Article in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 33 citations in OpenAlex.
- Cardiac output-guided haemodynamic therapy for patients undergoing major gastrointestinal surgery: OPTIMISE II randomised clinical trial.BMJ (Clinical research ed.) · 2024Trial
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- Safety of routine antimicrobial prophylaxis for surgery (SAPPHIRE): a prospective multi-centre cohort study.EClinicalMedicine · 2026Article
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
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- Trends in Paediatric surgerical volume and associated mortality in England: a nationwide study over an eight year period.BJA open · 2025Article
- Associations of multimorbidity with mortality, hospital stay, and hospitalization costs in Chinese surgical patients: a retrospective cohort study.BMC anesthesiology · 2025Observational
- Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia.BMC public health · 2025Article
- Preoperative risk factors for suboptimal initial clinical response or weight regain in patients undergoing bariatric surgery, a retrospective cohort study from a high-volume center.Langenbeck's archives of surgery · 2025Article
- Characteristics of older patients undergoing surgery in the UK: SNAP-3, a snapshot observational study.British journal of anaesthesia · 2025Observational
- Association between multimorbidity and quality of life after hip replacement surgery: analysis of routinely collected patient-reported outcomes.British journal of anaesthesia · 2025Article
- Article
- Socioeconomic and ethnic disparities associated with access to cochlear implantation for severe-to-profound hearing loss: A multicentre observational study of UK adults.PLoS medicine · 2024Observational
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe average age of the surgical population continues to increase, as does prevalence of long-term diseases. However, outcomes amongst multi-morbid surgical patients are not well described.
methodsWe included adults undergoing non-obstetric surgical procedures in the English National Health Service between January 2010 and December 2015. Patients could be included multiple times in sequential 90-day procedure spells. Multi-morbidity was defined as presence of two or more long-term diseases identified using a modified Charlson comorbidity index. The primary outcome was 90-day postoperative death. Secondary outcomes included emergency hospital readmission within 90 days. We calculated age- and sex-adjusted odds ratios (OR) with 95% confidence intervals (CI) using logistic regression. We compared the outcomes associated with different disease combinations.
resultsWe identified 20 193 659 procedure spells among 13 062 715 individuals aged 57 (standard deviation 19) yr. Multi-morbidity was present among 2 577 049 (12.8%) spells with 195 965 deaths (7.6%), compared with 17 616 610 (88.2%) spells without multi-morbidity with 163 529 deaths (0.9%). Multi-morbidity was present in 1 902 859/16 946 808 (11.2%) elective spells, with 57 663 deaths (2.7%, OR 4.9 [95% CI: 4.9-4.9]), and 674 190/3 246 851 (20.7%) non-elective spells, with 138 302 deaths (20.5%, OR 3.0 [95% CI: 3.0-3.1]). Emergency readmission followed 547 399 (22.0%) spells with multi-morbidity compared with 1 255 526 (7.2%) without. Multi-morbid patients accounted for 57 663/114 783 (50.2%) deaths after elective spells, and 138 302/244 711 (56.5%) after non-elective spells. The rate of death varied five-fold from lowest to highest risk disease pairs.
conclusionOne in eight patients undergoing surgery have multi-morbidity, accounting for more than half of all postoperative deaths. Disease interactions amongst multi-morbid patients is an important determinant of patient outcome.
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