Non-technical complications predict 30-day perioperative mortality in abdominal surgery. A propensity score matched analysis
Non-technical complications predict 30-day perioperative mortality in abdominal surgery. A propensity score matched analysis

Summary/Abstract: ntroduction: Surgical complications are a major cause of mortality and morbidity. Non-technical complications seem to be more dangerous than technique-related complications, however they are commonly neglected by surgeons. Aim: To study the relationship between non-technical complications and mortality after gastrointestinal and hepatobiliary surgery. Material and Methods: All gastrointestinal and hepatobiliary procedures performed over 3 years in one center were analysed. Non-technical postoperative complications were defined as perioperative complications related to patients’ physiological health or comorbidities, rather than surgical procedures or techniques. To avoid selection bias we conducted a 1:1 propensity score match analysis with non-technical complications as a dependent factor. The propensity scores were calculated using logistic regression. Preoperative confounding factors such as age, sex, American Society of Anesthesiologists (ASA) score and type of surgery were entered into our model as covariates. We used the nearest-neighbor protocol with a caliber of 0.2. The cases were not reusable after matching. The statistics were analyzed using SPSS version 23. Results: A total of 348 patients underwent gastrointestinal and HPB (Hepato Pancreatico Biliary) surgery in Hepatobiliary and Liver Transplant Department of Shalby Hospitals, India between April 2017 and March 2020. Twenty-four patients developed non-technical complications. ASA scores independently predicted non-technical complications (p=0.001, odds ratio 3.955, 95% C.I.: 1.774–8.813). After matching with 23 controls, non-technical complications were still significantly correlated with mortality (p<0.0001). Intraoperative factors did not predict non-technical complications. Surgery-related complications were not associated with mortality after matching. Conclusion: Non-technical complications are associated with a significant risk of mortality

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