The long-term effects of postoperative complications

Abstract

This review examines the long-term influence of postoperative complications on survival. Although it is intuitive that complications after surgery worsen short-term outcomes, it is not clear to what extent and why a longer-term relationship may exist. Most studies have focused on outcomes after cancer surgery. Despite mixed results in smaller cohorts, large multicentre analyses consistently identify an association between postoperative complications and long-term mortality. In part, this phenomenon may be due to unmeasured confounding factors or insufficient separation of short and long-term consequences. Nevertheless, functional and biological imprints established during postoperative complications are likely to be relevant, and are the subject of ongoing research. Patients that develop postoperative complications and survive the immediate risk period, demonstrate worsened long-term mortality. The field of perioperative medicine is increasingly mandated to identify vulnerable individuals, develop and implement strategies to prevent and treat complications, and provide better care pathways after hospital discharge.