Faculty, Staff and Student Publications

Language

English

Publication Date

4-9-2025

Journal

Nature Communications

DOI

10.1038/s41467-025-58161-2

PMID

40204694

PMCID

PMC11982547

PubMedCentral® Posted Date

4-9-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Perioperative organ injury contributes to morbidity and mortality of surgical patients. This cohort study included all elective and emergent surgeries in Germany over 4 years to address the impact of perioperative organ injuries on outcomes. We analyzed 28,350,953 cases. In-hospital mortality was 1.4% (n = 393,157), and 4.4% of cases (n = 1,245,898) experienced perioperative organ injury. Perioperative organ injury was associated with 9-fold higher odds of death and prolonged hospital stay by 11.2 days. Acute kidney injury had the highest incidence (2.0%) and was associated with 25.0% mortality. While delirium had the second highest incidence (1.5%), it was associated with the lowest mortality (10.8%). This was followed by acute myocardial infarction (incidence 0.6%, mortality 15.6%), stroke (incidence 0.6%, mortality 13.1%), pulmonary embolism (incidence 0.3%, mortality 20.0%), liver injury (incidence 0.1%, mortality 68.7%), and acute respiratory distress syndrome (incidence 0.1%, mortality 44.7%). These findings help prioritize interventions for preventing or treating individual types of perioperative organ injury.

Keywords

Humans, Male, Female, Middle Aged, Aged, Germany, Hospital Mortality, Acute Kidney Injury, Incidence, Pulmonary Embolism, Length of Stay, Adult, Postoperative Complications, Myocardial Infarction, Cohort Studies, Perioperative Period, Respiratory Distress Syndrome, Stroke, Aged, 80 and over, Surgical Procedures, Operative

Published Open-Access

yes

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