Anesthetic Management and One-Year Mortality After Noncardiac Surgery

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Abstract
Eoperative clinical, surgical, or intraoperative variables. One-year mortality was 5.5% in all patients (n = 1064) and 10.3% in patients ≥65 yr old (n = 243). Multivariate Cox Proportional Hazards modeling identified three variables as significant independent predictors of mortality: patient comorbidity (relative risk, 16.116; P < 0.0001), cumulative deep hypnotic time (Bispectral Index® <45) (relative risk = 1.244/h; P = 0.0121) and intraoperative systolic hypotension (relative risk = 1.036/min; P = 0.0125). Death during the first year after surgery is primarily associated with the natural history of preexisting conditions. However, cumulative deep hypnotic time and intraoperative hypotension were also significant, independent predictors of increased mortality. These associations suggest that intraoperative anesthetic management may affect outcomes over longer time periods than previously appreciated....