Predictors of Postoperative Complications in Gastrointestinal Surgery

Surgical site infections and wound dehiscence are well-known postoperative complications that cause high mortality and morbidity. The aims of this study were to identify and evaluate the predictors of the following complications: infection and wound dehiscence. This study was performed between Jan 2007 and Apr 2008, and a cohort of 525 consecutively operated patients was evaluated. The operations were performed at the Surgery Clinic, Clinical Center Nis. Of the total number, there were 338 (64,38%) elective and 187 (35,61%) emergency operations. The analysis of factors associated with complications following elective surgery disclosed that smoking, comorbidity, blood loss, and type of operation were independent predictors. Multivariate subgroup analysis of the association between smoking and complications disclosed that smoking was independently associated with surgical site infections, as well wound dehiscence. In emergency surgery, male gender, peritonitis, operation, and multiple operations were independent predictors. The association between complications and blood loss disclosed a significant dose-relationship, signifying that a large blood loss yielded a higher risk of complications. The risk factors of wound dehiscence can be predicted early and their number can be decreased before and after surgery by an experienced surgeon, leading to a lowered incidence of wound failure. Acta Medica Medianae 2008;47(3):15-20.