title: Long-Term Survival After Complications Following Major Abdominal Surgery.
abstract: Postoperative complications have been associated with decreased long-term survival in cardiac, orthopedic, and vascular surgery. For major abdominal surgery research, conflicting evidence is reported in smaller studies. The aim of this study was to assess the effect of complications on long-term survival in major abdominal surgery.
  
  
  
  An observational cohort study was conducted of 861 consecutive patients that underwent major abdominal surgery between January 2009 and March 2014, with prospective assessment of the survival status. The effect of postoperative complications on survival was assessed.
  
  
  
  Postoperative complications were associated with decreased survival, even after applying correction for 30-day mortality (p < 0.001). Stratified Cox regression analysis depicted postoperative complications to be an important predictor for survival in upper gastrointestinal and female hepatopancreaticobiliary patients. Correction was applied for age, gender, BMI, ASA classification, radicality, and positive lymph node status.
  
  
  
  These results further indicate the importance of prevention and early diagnosis and treatment of complications. Etiological factors are believed to be both sustained levels of inflammatory markers, as well as attenuated immune response in malignancy with subsequent cancer cell seeding. Future research should aim to prevent and early diagnose postoperative complications to prevent morbidity and mortality not only in the early postoperative phase, but also in the long term.
authors: Department of Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands. je.straatman@vumc.nl.
authors: Jennifer
authors: J
authors: Straatman
authors: Department of Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands.
authors: Miguel A
authors: MA
authors: Cuesta
authors: Department of Epidemiology and Biostatistics, VU University Medical Center, van der Boechhorststraat 7, 1081 BT, Amsterdam, The Netherlands.
authors: Elly S M
authors: ES
authors: de Lange-de Klerk
authors: Department of Surgery, VU University Medical Center, De Boelelaan 1117, ZH 7F020, 1081 HV, Amsterdam, The Netherlands.
authors: Donald L
authors: DL
authors: van der Peet
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Major abdominal surgery; Postoperative complications; Survival