Adverse outcomes epidemiology in elective abdominal surgery: results of a prospective observational multicenter study

INTRODUCTION: Risk assessment and identification of the group of patients with a high probability of developing an unfavorable outcome is the basis for effective prevention of postoperative adverse events. OBJECTIVE: To determine the incidence, pattern, severity and day of development of postoperative complications in patients after elective abdominal surgery based on STOPRISK database analysis. METHODS: The data of 11 478 patients in the STOPRISK database were analyzed. Gender, age, comorbidity, anesthesia and operative characteristics were recorded in all patients after assessment of compliance with the inclusion criteria. In the postoperative period, 30-day complications according to European Society of Anaesthesiology и European Society of Intensive Care Medicine classification and mortality were recorded. RESULTS: Of the 11 478 patients, 521 (4.5 %) developed complications in the postoperative period and 71 (0.62 %) developed fatal complications. Thus, among cardiac complications, arrhythmias occurred predominantly on days 1–3, 4–5, and 6–8; non-fatal cardiac arrest, acute myocardial infarction, and pulmonary embolism were observed in almost every time period. An overwhelming number of cases of cardiogenic pulmonary edema and acute cerebral circulatory failure were detected in the 1–3 day postoperative period. Among respiratory complications (acute respiratory distress syndrome, pneumonia, acute respiratory failure) the greatest number occurred before 8 days. Infectious complications (wound infection, sepsis) predominantly developed on the 4th–8th day. Cerebral complications (delirium) and renal complications (acute kidney injury) — predominantly on day 1–3. Surgical complications (anastomosis failure, intestinal paresis, postoperative bleeding and wound edge divergence) — at all stages of observation, but predominantly on days 1–3 and 4–8. CONCLUSIONS: The most frequent complication in the general population was intestinal paresis, followed by wound infection, postoperative bleeding, pneumonia, and the least frequent complications were STEMI and non-fatal cardiac arrest. 62 % of complications were of severe degree (III and higher). © 2025 Elsevier B.V., All rights reserved.