title: Unplanned surgical reoperations in a tertiary hospital:  perioperative mortality and associated risk factors.
abstract: OBJECTIVE
  The aim of the study was to estimate the rate of unplanned surgical reoperations in a tertiary hospital and the mortality in reoperated patients and to determine factors associated with risk of mortality in these patients.
  
  
  METHODS
  Unplanned surgical reoperations in our hospital were recorded from 1 May 2006 to 31 March 2008. Unplanned reoperation was defined as any surgical procedure required to treat a complication of a prior procedure within the first 30 days of the initial operation. Patients were followed until hospital discharge.
  
  
  RESULTS
  Of 11,468 patients who underwent surgery, 381 (3.3%) required reoperation. The main indications for the second or subsequent procedure were postsurgical bleeding (26.3%) and infection (31.2%). Mortality was higher in reoperated patients (21.7 vs. 2.9% in nonreoperated patients, P<0.05). Age, number of reoperations, reoperation of patients before discharge from the postoperative care unit, acute abdomen as the indication for reoperation and reoperation in the thoracic cavity were independently associated with mortality.
  
  
  CONCLUSIONS
  Unplanned reoperations have important implications for patient outcomes and are related to high mortality. Certain patient-related and procedure-related factors increase risk.
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, Complejo Hospitalario Universitario A Coruña, Coruña, Spain. prmaceiras@wanadoo.es
authors.forename: Pablo
authors.initials: P
authors.lastname: Rama-Maceiras
authors.forename: Teresa
authors.initials: T
authors.lastname: Rey-Rilo
authors.forename: Esther
authors.initials: E
authors.lastname: Moreno-Lopez
authors.forename: Nieves
authors.initials: N
authors.lastname: Molins-Gauna
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Sanduende-Otero
authors.forename: Alberto
authors.initials: A
authors.lastname: Pensado-Castiñeiras
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D019106:Postoperative Hemorrhage / Q000601:surgery; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data*; D012307:Risk Factors; D013030:Spain; D013530:Surgical Wound Infection / Q000601:surgery