Epidemiology of adverse outcomes in high surgical risk patients in elective abdominal surgery: results of a prospective observational multicenter study

To describe the epidemiology of postoperative complications in high risk patients undergoing elective abdominal surgery and to compare their outcomes with the overall STOPRISK cohort. A prospective, multicenter observational cohort study was conducted in 38 Russian centers and included 11,478 adults undergoing elective surgery on abdominal and pelvic organs; among them, 1,367 patients (11.9 %) met guideline based criteria for high surgical risk. Postoperative complications within 30 days were recorded according to EPCO definitions and graded using the Clavien–Dindo classification, with detailed assessment of frequency, structure, severity and timing. CONCLUSIONS: High risk surgical patients, while representing a small proportion of the elective abdominal population, account for a disproportionally large share of severe complications and deaths. These findings support the implementation of targeted protocols for intensive monitoring, early diagnosis and prevention during the early postoperative window, as well as refinement of national perioperative risk stratification tools and resource planning.本研究旨在描述接受择期腹部手术的高危患者术后并发症的流行病学特征，并将其转归与整体STOPRISK队列（STOPRISK）进行对比。本研究为一项前瞻性多中心观察性队列研究，在38家俄罗斯医疗中心开展，共纳入11478名接受腹部及盆腔器官择期手术的成年患者；其中1367名患者（占比11.9%）符合基于指南的高危手术风险判定标准。研究依据EPCO定义（EPCO）记录术后30天内的并发症情况，并采用克拉维恩-丁多分级系统（Clavien–Dindo）进行分级，同时对并发症的发生频率、构成结构、严重程度及发生时间开展详细评估。 结论：高危手术患者虽仅占择期腹部手术患者群体的一小部分，却在严重并发症及死亡病例中占据了远超其群体占比的份额。本研究结果支持在术后早期阶段实施针对性的强化监测、早期诊断及预防方案，同时也有助于完善全国围手术期风险分层工具及医疗资源规划工作。