I get like heart surgery would be low but what effects the percentage? if a theoretical perfect surgen was doing it would the odds be 100% or would it still depend on other factors?
In: Biology
Not a doctor so a surgeon can provide more detail but even if a surgeon executes the surgery flawlessly, there’s always risk of complications.
There’s always a risk of post-op complications, higher risk with more invasive procedures. Sometimes the patient develops an infection. Sometimes, the initial damage was so severe that even with the best surgical efforts, they are unable to recover. Other times, patients are too sick or weak and end up dying on the operating table.
Over time with many patients, we get an idea of how successful the surgery is. The survival chance is not “how good the surgeon is,” it’s more like how successful is this specific surgery in treating/curing the specific condition that caused the procedure to be necessary
Survival chance is due to a lot of factors – I’ll try and go chronologically.
**Before surgery**
* Condition of the patient – is this a trauma call where they’re already close to death, or an elective surgery that can be planned for?
* Co-morbidities – pre-existing conditions. Is the patient massively overweight? Do they have other health issues? What’s their anaesthesia risk (which can be calculated beforehand)? Do they have any clotting conditions? Etc.
* Availability of imaging – does the surgeon know what’s wrong with the patient? Do they understand their anatomy? Can they plan a surgical approach, or will they have to wing it?
**During surgery**
* Skill of the surgeon – everyone can make mistakes. If someone has done a procedure hundreds of times then they’ll be better able to adjust their process to account for anything unexpected.
* Skill of the anaesthetist, and other staff – everybody has to work as a team in theatre. If shit hits the fan, are more skilled surgeons and specialists available to take over?
* Risk of the procedure – some procedures are inherently risky. Operating on major blood vessels, the brain, the heart etc. all come with risks.
* Control over the procedure – what if the patient just starts bleeding? What if a clamp slips? What if the patient starts seizing or slips deeper into anaesthesia?
* Stress the surgery puts on the patient – related to the risks, but particularly long, invasive or significant surgeries out the patient’s body under more stress.
**After surgery**
* Emergence from anaesthesia – is the patient brought round in a controlled manner? Do they remain unstressed?
* Post-operative complications – this can be anything from bleeding, to bowel perforations, to adhesions etc. etc. We can predict the likelihood of these complications, but it’s hard to apply to individual cases.
* Infection control – can we keep the incisions and surgical sites free from infection? The patient may be put on preventative antibiotics for this, but anything can happen. It’s one of the reasons why orthopaedic surgeons regularly use the big boy antibiotics – bone infections can be incredibly challenging to treat.
** Further down the line**
This kinda falls under survival chances of the procedure, but the patient should have ongoing post-operative care and rehabilitation. They need to have their wound dressings changed, vitals monitored, mobilised to prevent bed sores and DVTs, and potentially undergo physical rehabilitation to regain fitness and maximise chances of a successful outcome.
All of this varies massively between procedures and patients, as well as varying between surgeons. We can predict some of it, but some of it is uncertain until the patient is open on the table. Some of it is sheer bloody luck, unfortunately – you can do everything right but still lose a patient.
Hope this helps!
There’s some good responses here, but one other factor would be data on prior outcomes from similar surgery. So, if a surgeon had carried out 1,000 procedures of a specific kind and of all those cases 500 patients survived, they could say that the chance of survival is likely to be 50%. Obviously that would be adjusted by the surgeon for individual cases taking into account the factors mentioned above in the previous comments.
There’s a couple of surgery risk calculators available for free online. Search for:
“Gupta Calculator”
Or
“RCRI Calculator”
Plug in your values, or your family member, and check for yourselves!
Latest Answers