AI Article Synopsis
- The study analyzes operative mortality in over 7,000 cases at a Veterans Administration Medical Center, revealing that while elective procedures generally have low mortality, older patients and those with malignant diseases face higher risks.
- Sepsis is identified as the leading cause of death following both elective and emergency surgeries, with age and preexisting health conditions significantly impacting outcomes.
- Hospitals dedicated to resident training can achieve better mortality rates, often through intensive preoperative care and extended postoperative support, though this requires substantial resources.
Article Abstract
The operative mortality in over 7,000 consecutive cases at a Veterans Administration Medical Center is defined. The mortality in elective procedures is low by most standards and is usually associated with a malignant disease. Older patients appear to have an increased operative mortality. Sepsis is the major factor in death after elective and emergency procedures. Age is a critical factor associated with mortality in this population. Preexisting disease (pulmonary, cardiac, hepatic, and malignant) plays a role in determining outcome. Despite these factors it is possible to achieve excellent operative mortality results in a hospital with a commitment to resident training. An aggressive diagnostic and therapeutic approach is considered reasonable to support these patients with multisystem disease. This often includes the extensive use of expensive resources such as preoperative hospitalization with nutritional support and prolonged stays in the surgical intensive care unit postoperatively.
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| http://dx.doi.org/10.1016/0002-9610(82)90596-7 | DOI Listing |
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