Background: Post-surgical procedure-related mortality is a critical area of healthcare, frequently linked to complications such as excessive bleeding, sepsis, organ failure or adverse reactions to anesthesia. Given the devastating nature of these complications and their effects on patient safety, the importance of robust surgical protocols and post-op monitoring is highlighted. This study analyzed trends and disparities in mortality rates due to post-surgical complications among adults from different demographics and geographical locations from 1999 to 2020 in adults aged 25 and older.
Methods: Analysis of post-surgical procedure-related deaths in the US from 1999-2020 was conducted using death certificate data from the CDC WONDER database, utilizing the ICD-10 code Y83. Age-adjusted mortality rates (AAMR) per 1,000,000 population were extracted, and trends were analyzed using Joinpoint regression to calculate the Average Annual Percent Change (AAPC) with p value for statistical significance. Data were stratified using year, gender, race/ethnicity and geographical regions.
Results: Between 1999 and 2020, post-surgical procedure-related complications caused 381093 deaths among adults aged >25 years in the U.S. The overall AAMR for Post-surgical procedure-related deaths decreased from 12.12 in 1999 to 10.93 in 2020, the AAPC for this period is -0.51 (p< 0.05). Men displayed significantly higher AAMRs as compared to women (10.07 vs. 6.48), but there is a steeper decline in mortality in women (AAPC: -0.88, p< 0.01) in comparison to men (AAPC: -0.42, p>0.05). There was significant disparity among different races, with Black individuals having the highest AAMR (9.64), followed by American Indians or Alaska Natives (9.37), Whites (8.13), Hispanics (6.00) and Asian or Pacific Islander (4.4). Nonmetropolitan areas had a higher AAMR (9.75) as compared to Metropolitan areas (7.65). Both observed a significant decrease from 1999 to 2020 (Metropolitan: AAPC: -0.47, p>0.05; Non-metropolitans: AAPC: -0.64, p< 0.01). In geographical stratification, the highest AAMRs were observed in Mississippi (12.52) and lowest in Massachusetts (4.97). The Midwest region of the U.S had the highest AAMR (8.57), followed by the South (8.33), West (7.83), and Northeast (6.93). Most deaths occurred in Medical facilities (77.43%), followed by Decedent’s home (10.81%), nursing homes (7.48%), hospice (2.16%), and 2.12% deaths occurred at other places.
Conclusions: Over the past two decades, post-surgical procedure-related mortality in the USA has decreased marginally. Higher mortality rates were observed in males, Black individuals, and Nonmetropolitan areas, with the Midwest showing the greatest regional increase. These findings highlight the demographic disparities, need for improved procedural safety and targeted interventions in high-risk populations.
