Initial postoperative complications can lead into subsequent secondary complications, though there is little empirical evidence on the correlation between the two.
Researchers analyzed approximately 890,000 patients who underwent elective inpatient surgery between 2005 and 2011, identified in the American College of Surgeons National Surgical Quality Improvement Program.
They examined index complications and determined their related secondary complications. The study's findings are published in JAMA Surgery.
Index pneumonia was associated with increased odds of 30-day reintubation, ventilatory failure, sepsis and shock.
Heart attacks were associated with increased rates of secondary bleeding or transfusion events, pneumonia, cardiac arrest and reintubation.
Deep space surgical site infections were related to wound rupture, sepsis, shock, kidney injury and acute renal failure.
Acute renal failure was linked to increased odds of cardiac arrest, reintubation, ventilatory failure, bleeding or transfusion events and shock.
Researchers conclude their investigation demonstrated the effect of index complications on the risk of specific secondary complications. "The defined pathways merit investigation as unique targets for quality improvement and benchmarking," they conclude.
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