Severity of disease scoring systems and mortality after non-cardiac surgery

• Main Authors: Pedro Videira Reis, Gabriela Sousa, Ana Martins Lopes, Ana Vera Costa, Alice Santos, Fernando José Abelha
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Anestesiologia
• Series: Revista Brasileira de Anestesiologia
• Subjects: Postoperative mortality; Severity of disease scoring systems; APACHE II; SAPS II; Surgical intensive care unit; Non-cardiac surgery
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000300244&lng=en&tlng=en

Abstract Background: Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. Methods: Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI). Results: 4398 patients were included. Mortality was 1.4% in surgical intensive care unit and 7.4% during hospital stay. Independent predictors of mortality in surgical intensive care unit were APACHE II (OR = 1.24); emergent surgery (OR = 4.10), serum sodium (OR = 1.06) and FiO2 at admission (OR = 14.31). Serum bicarbonate at admission (OR = 0.89) was considered a protective factor. Independent predictors of hospital mortality were age (OR = 1.02), APACHE II (OR = 1.09), emergency surgery (OR = 1.82), high-risk surgery (OR = 1.61), FiO2 at admission (OR = 1.02), postoperative acute renal failure (OR = 1.96), heart rate (OR = 1.01) and serum sodium (OR = 1.04). Dying patients had higher scores in severity of disease scoring systems and longer surgical intensive care unit stay. Conclusion: Some factors influenced both surgical intensive care unit and hospital mortality.