Association Between Hospital Perioperative Quality and Long-term Survival After Noncardiac Surgery

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Abstract
Nearly 20 million operations are performed in the US every year.1 However, the quality and safety of surgical care varies widely, with nearly 2-fold variation in risk-adjusted perioperative mortality across hospitals.2,3 Although many factors likely play a role in this outcome variability, short-term variation in hospital perioperative mortality has primarily been attributed to institutional differences in the management, rather than the prevention, of complications.2,4,5 Many structural and microsystem factors (eg, increased nurse-patient ratios, improved communication between care team members, and institutional safety culture) have been associated with more timely identification and treatment of complications.6-9 These factors are believed to directly influence more proximate postoperative outcomes, but it is possible that they could also affect patients’ longer-term survival.

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