Riskiest Time for Hospital Patients is Not in Operating Room

A new study suggests that the deadliest time for many hospital patients is not when they are in the operating room. Instead, it is the period when patients are recovering in the hospital and after they go home.

一项新的研究表明，对许多医院病人来说，最致命的时间不是在手术室。相反，这是病人在医院康复和回家后的时期。

Researchers examined medical records of more than 40,000 patients, aged 45 years and older. The records came from 28 hospitals in 14 countries. Doctors had performed surgery on each patient, but none of the operations was related to the heart.

研究人员检查了40000多名45岁及以上患者的病历。这些记录来自14个国家的28家医院。医生对每个病人都做过手术，但没有一个手术与心脏有关。

The researchers looked for patients with health problems or death within 30 days of surgery.

研究人员在手术后30天内寻找有健康问题或死亡的病人。

A total of five people died during the operation. That represents less than 1% of all patients. Another 500 patients, or 70%, died in the hospital. And 210 deaths, or 29%, did not happen until after patients were sent home.

手术中共有5人死亡。不到所有病人的1%。另有500名病人在医院死亡，占70%。210例死亡，占29%，直到病人被送回家后才发生。

Nearly half of all the deaths were linked to one of three problems: major bleeding, heart damage and blood infections.

几乎一半的死亡与三个问题之一有关：大出血、心脏损伤和血液感染。

P.J. Devereaux is with McMaster University in Canada and was the lead writer of a report on the study. The report was published in the Canadian Medical Association Journal.

P.J.Devereaux是加拿大麦克马斯特大学的一名研究报告的主要作者。该报告发表在加拿大医学会杂志上。

Devereaux wrote that the research shows very few deaths happen in the operating room. He added that "there is a need to focus on post-operative care and transitional care into the home setting to improve outcomes." His comments were part of an email sent to the Reuters news agency.

Devereaux写道，研究显示手术室很少有人死亡。他补充说，“有必要把重点放在术后护理和家庭过渡护理上，以改善治疗效果。”他的评论是发给路透社的一封电子邮件的一部分。

Worldwide, 100 million patients age 45 and older have surgeries unrelated to heart-related issues every year.

全世界每年有1亿45岁及以上的患者接受与心脏相关问题无关的手术。

The researchers noted that technological and medical improvements have made such surgeries safer and less invasive in recent years. However, patients are also coming to the hospital sicker and being sent home with complex care needs.

研究人员指出，近年来，技术和医疗的进步使得此类手术更安全、侵入性更小。然而，病人也来医院看病，并被送回家与复杂的护理需求。

In the study, about half of the patients had high blood pressure. One in five had the disease diabetes, while 13% had heart disease.

在这项研究中，大约一半的病人患有高血压。五分之一患有糖尿病，13%患有心脏病。

More than one-third of them came in only for low-risk treatments that were not emergency operations.

超过三分之一的病人只接受非紧急手术的低风险治疗。

Patients who experienced major bleeding after surgery were more than two times as likely to die within 30 days as people who did not have this complication. In addition, patients who developed heart injuries were also more than twice as likely to die.

术后出现大出血的患者在30天内死亡的可能性是没有这种并发症的患者的两倍多。此外，发生心脏损伤的患者死亡的可能性也是前者的两倍多。

The study was not a controlled experiment designed to identify which if any complications actually caused any deaths.

这项研究并不是一项旨在确定哪些并发症会导致死亡的对照实验。

Barnaby Charles Reeves is with the University of Bristol in Britain. He told Reuters in an email that inflammation might be a common link to the health problems that were most responsible for deaths. 

巴纳比·查尔斯·里夫斯在英国布里斯托尔大学工作。他在一封电子邮件中告诉路透社，炎症可能是导致死亡的最主要健康问题的常见联系。

He noted that, "Surgery causes a body-wide inflammatory reaction. This can lead to single or multi-organ failure which leads to death."

他指出，“手术引起全身炎症反应。这可能导致单器官或多器官衰竭，导致死亡。”

P.J. Devereaux said that patients might also not recognize that something is wrong when they begin to stop taking pain medication after surgery.

P.J.Devereaux说，当病人在手术后开始停止服用止痛药时，他们可能也不会意识到有问题。

The researchers called for more research into improved methods for observing the condition of hospital patients after surgery. They said these methods can help identify ways to lower the risk of death following an operation.

研究人员呼吁进一步研究改进的方法，以观察手术后住院病人的情况。他们说，这些方法有助于确定降低手术后死亡风险的方法。