Postoperative complications are much more common than intraoperative and anesthesia-related complications. According to the International Surgical Outcome Study, approximately 17% of inpatients undergoing elective surgery develop at least one postoperative complication. This proportion reaches 27% in patients undergoing major surgery and exceeds 30% in patients with significant comorbidities (American Society of Anesthesiologists status III to IV). A large (84,730 patients) observational study demonstrated that U.S. hospitals having similar postoperative complication rates may report very different mortality rates. These findings are likely explained by differences in the detection and treatment of complications and suggest that postoperative mortality is, at least in part, preventable.

On hospital wards, where the nurse-to-patient ratio is lower than in postanesthesia care units or intensive care units (ICUs), a recent and large study (48,864 patients) showed that approximately one third of...

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