Early Determinants of Death Due to Multiple Organ Failure After Noncardiac Surgery in High-Risk Patients

Abstract

MOF is the main cause of death after surgery in high-risk patients. Awareness of the risk factors for death due to MOF may be important in risk stratification and can suggest routes for therapy.

A pragmatic multi-center trial of goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery

“…All of these criteria have been used in previous studies, [2, 16] and they were adopted for this study. Patients with severe aortic regurgitation, cardiac arrhythmias, congestive heart failure, patients undergoing renal replacement therapy, those undergoing palliative surgery were excluded from the study.…”

“…This is particularly true of fluid loading. Volume management in the perioperative period plays a pivotal role in resuscitation and, hence, morbidity and mortality in surgical patients [2]. Excessive fluid administration may aggravate pulmonary dysfunction, prolong the need for mechanical ventilation, extend the hospital length of stay and increase postoperative mortality [9].…”

Systematic review of the impact of HbA1c on outcomes following surgery in patients with diabetes mellitus

“…Diabetes is a significant risk factor for complications following many forms of surgery [3]. It increases the incidence of infection [4e6], as well as general morbidity and mortality [7,8]. Diabetes is associated with other comorbidities which increase the risk of surgical intervention, particularly cardiovascular adverse events [9].…”

Remote ischemic preconditioning and outcome

“…Irrespective of the therapy we apply, acute organ injury, which may lead to single or multiple organ failure, is the leading cause of death in the perioperative phase [3]. The mortality rate of surgical critically ill patients is as high as 21%, and the acute multiple organ dysfunction syndrome is with 47-53% the most common cause of death in this patient population [3,4].…”

“…Irrespective of the therapy we apply, acute organ injury, which may lead to single or multiple organ failure, is the leading cause of death in the perioperative phase [3]. The mortality rate of surgical critically ill patients is as high as 21%, and the acute multiple organ dysfunction syndrome is with 47-53% the most common cause of death in this patient population [3,4]. In critically ill patients, organ dysfunction emerges basically from sepsis, whereas in perioperative surgical patients organ dysfunction primarily evolves in the wake of a systemic inflammatory response syndrome [5].…”