3 leading causes of patient deaths after noncardiac surgery

In a study of about 40,000 patients from 14 countries, myocardial injury, major bleeding, and sepsis were the top three causes of patient deaths after noncardiac surgery, according to the European Society of Cardiology.

Patients in the study were adults age 45 and older who had noncardiac surgery and stayed in the hospital for at least one night. 

The researchers found 715 (1.8 percent) patients died within 30 days after noncardiac surgery. Of those patients, 505 (71 percent) died in the hospital, and 210 (29 percent) died after they were released.

Eight perioperative complications, five of which were cardiovascular, were linked to death within 30 days after operation.

The top three complications, which contributed to nearly three-quarters of all deaths, were myocardial injury after noncardiac surgery (29 percent), major bleeding (25 percent), and sepsis (20 percent).

"We're letting patients down in postoperative management," said principal investigator professor Philip Devereaux, MD, PhD, director of cardiology at McMaster University in Ontario, Canada. "The study suggests that most deaths after noncardiac surgery are due to cardiovascular causes, so cardiologists have a major role to play to improve patient safety."

To improve patient safety, clinicians can conduct blood and imaging tests to find patients at risk then give preventive treatment, such as medications to prevent abnormal heart rhythms, lower blood pressure and cholesterol and prevent blood clots, Dr. Devereaux said.

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