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
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!
Latest Answers