Evidence map›Paper›PMID 42263161›Full record

ArticleJMIR perioperative medicine2026

Association Between Complications and Death Within 30 Days After Orthopedic Surgery: Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) Substudy.

Lily J Park, P J Devereaux, Ameen Patel, Vikas Tandon, Diane Heels-Ansdell, Lehana Thabane, Pablo E Serrano, Matthew T V Chan, Wojciech Szczeklik, Sadeesh Srinathan and 22 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR perioperative medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Lily J ParkDepartment of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-0372-3525
P J DevereauxPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0003-2935-637X
Ameen PatelPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0002-9338-2815
Vikas TandonPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0009-0007-0257-3936
Diane Heels-AnsdellDepartment of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-4362-801X
Lehana ThabaneDepartment of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-0355-9734
Pablo E SerranoDepartment of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-3715-6880
Matthew T V ChanChinese University of Hong Kong, Hong Kong, China (Hong Kong).ORCID 0000-0002-3574-7855
Wojciech SzczeklikCentre for Intensive Care and Perioperative Medicine, Jagiellonian College, Krakow, Kujawsko-Pomorskie, Poland.ORCID 0000-0002-1349-1123
Sadeesh SrinathanDepartment of Surgery, University of Manitoba, Winnipeg, MB, Canada.ORCID 0000-0002-4972-3619
Ignacio GaruttiDepartment of Medicine, Universidad Complutense de Madrid, Madrid, Spain.ORCID 0000-0001-8284-2903
Gerard UrrutiaInstitut de Recerca Sant Pau (IR SANT PAU) - CIBERESP, Barcelona, Spain.ORCID 0000-0002-8850-0960
Ernesto Guerra-FarfanDepartment of Surgery, Division of Orthopedic surgery, Vall d'Hebron Hospital Universitari, Barcelona, Catalonia, Spain.ORCID 0000-0001-5445-1331
Hassaan Abdel KhalikDepartment of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-1051-3144
Emmanuelle DuceppeDepartment of Medicine, Université de Montréal, Montreal, QC, Canada.ORCID 0000-0002-1457-2945
Sandra OforiPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0002-1691-0979
Maura MarcucciPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0002-8468-7991
David ConenPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0002-2459-5251
Michael K WangPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0009-0005-7016-0872
Jessica SpencePopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0003-1267-9455
Daniel TushinskiDepartment of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-2117-4654
Kamal BaliDepartment of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-0109-6449
Anthony AdiliDepartment of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-4692-819X
Vickas KhannaDepartment of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0009-0005-8274-0444
Ana Claudia TonelliInternal Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.ORCID 0000-0003-0903-6774
Francesca MulazzaniDepartment of Medicine, University of Milano-Bicocca, Milan, Lombardy, Italy.ORCID 0009-0003-8425-6117
Wenjun JiangFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.ORCID 0009-0008-7421-1245
Olufemi R AyeniDepartment of Surgery, Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-4219-8564
Gerard SlobegeanDepartment of Orthopedics, School of Medicine, University of California, Irvine, CA, United States.ORCID 0000-0002-9111-9239
Theodore MiclauDepartment of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, United States.ORCID 000-0001-7518-7293
Mohit BhandariDepartment of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-3556-9179
Flavia K BorgesPopulation Health Research Institute, 237 Barton St E, C1-109, Hamilton, ON, Canada, 1 (905) 527-4322 ext 40654.ORCID 0000-0001-5377-7612

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The contemporary causes of postoperative mortality in orthopedic surgery are not well characterized. Objective: This study aimed to describe the epidemiology of postoperative complications among adult patients who underwent orthopedic surgery and inform their relationships with 30-day mortality. Methods: Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) was a prospective cohort study involving 40,004 adult patients who underwent noncardiac surgery across 28 centers in 14 countries. For the subset of patients who underwent orthopedic surgery, a Cox proportional hazards model was used to determine time-dependent associations between various surgical complications and 30-day postoperative mortality. Analyses were adjusted for preoperative and surgical variables. Results: Among 8385 patients who underwent an orthopedic surgery in VISION, 1.6% (n=132) died within 30 days of surgery. Of the 132 deaths, 63.6% (n=84) occurred in hospital during the index hospitalization, while 36.4% (n=48) occurred after discharge. The incidence of death across the subcategories of orthopedic surgery was above-knee amputation (30/221, 13.6%), internal fixation of femur (29/750, 3.9%), lower leg amputation (9/252, 3.6%), major hip or pelvic surgery (49/2898, 1.7%), major spine surgery (8/1405, 0.6%), and knee arthroplasty (7/2876, 0.2%). A total of 6 postoperative complications (myocardial injury after noncardiac surgery [MINS], major bleeding, infection without sepsis, sepsis, stroke, and atrial fibrillation) were associated with death in adjusted analyses. The greatest attributable fractions of postoperative mortality (ie, proportion of deaths in the cohort that can be attributed to each complication, if causality were established) were from MINS (1454/8385, 17.3%; hazard ratio [HR] 2.08, 95% CI 1.38-3.14; P<.001; attributable fraction=20.6%), major bleeding (2422/8385, 28.9%; HR 1.95, 95% CI 1.34-2.85; P<.001; attributable fraction=16.5%), and sepsis (318/8385, 3.8%; HR 6.24, 95% CI 3.85-10.12; P<.001; attributable fraction=9.7%). Conclusions: The complications most attributable to 30-day mortality following orthopedic surgery were MINS, major bleeding, and sepsis. These findings highlight areas for further study to mitigate perioperative mortality in orthopedic surgery. MINS demonstrated the highest attributable fraction for mortality (20.6%), emphasizing the importance of appropriate MINS screening, diagnosis, and management.

Indexed as

Orthopedic ProceduresPostoperative ComplicationsAgedCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsProspective StudiesRisk Factorsmorbiditymortalityorthopedic surgeryperioperative medicinepostoperative complications

Identifiers

PMID42263161
PMCPMC13249062

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.