Complications During and After Surgery

Surgery complications happen mainly after surgery during recovery period

(RxWiki News) If going under the knife makes you wary, worry more about the time afterwards. New research shows that about 40 percent of surgical complications happen after surgery, with infections and blood clots being the biggest problems.

"We found that more than 40 percent of all post-operative complications occurred post-discharge; approximately 1 in 14 general surgery patients who underwent an inpatient procedure experienced a post-discharge complication," researchers said in a press release.

Problems at the surgery site, as well as infections and blood clots, were the most common complication amongst all procedures.

"Know what's happening before and after surgery."

The study, led by Hadiza Kazaure, MD, from the Department of General Surgery at Stanford University, included more than half a million patients averaging about 55 years old.

Each patient had one of 21 different surgical procedures. Researchers looked at files from the American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2012.

They pulled information on the type of procedure and the rates and risk factors for having some complication within a month after surgery. They found that 16.7 percent of patients had a complication with surgery and almost half of the complications came afterwards.

Surgery involving the rectum had the highest number of complications at almost 15 percent of cases. Repairing airways and pancreas surgery followed behind with about 13 and 11 percent of patients having complications respectively.

The greatest proportions of complications happened with breast, bariatric and hernia repairs at about 79 percent, 69 percent and 62 percent respectively.

About 13 percent of patients who had complications during surgery were more likely to have another problem come up afterwards, compared to only 6 percent of patients who were problem-free during the procedure.

And about 18 percent of those who had some complication after surgery had to have surgery again, compared to about 5 percent of patients without problems. The post-discharge problem group also had a slightly higher rate of death at about 7 percent of patients versus 2 percent in the other group.

"More research is needed to develop and explore the utility of a cost-effective and fastidious post-discharge follow-up system for surgical patients," researchers said in their report.

Patients that have some complication "should be considered at increased risk for post-discharge events," according to researchers. This includes patients whose procedures were in the top quarter of the longest-lasting operations. Researchers also found that patients who are obese, have diabetes or are taking some steroid therapy may need the most attention.

"Our findings could facilitate identification of patients at increased risk and allow for targeted preventive interventions," the authors wrote.

Educating patients on their complication risks after being released from the hospital may help prevent developing some problem, the authors said. And teaching patients how to care properly for wounds to prevent infection will also help.

The authors note they did not look at how hospitals that discharged patients early affected results and whether getting surgery again was related to the complication in the first place. They may also have underestimated the rate of complications. The study was published in the November issue of Archives of Surgery from the Journal of the American Medical Association. No conflicts of interest were reported. 

Reviewed by: 
Review Date: 
November 19, 2012