Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia
Abstract Background Multimorbidity, particularly prevalent among older patients, represents a growing global health challenge. This study investigates the prevalence of multimorbidity and its relationship with perioperative outcomes among older patients undergoing major surgery in Ethiopia. Methods...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12889-025-24034-y |
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| author | Amanuel Sisay Endeshaw Fantahun Tarekegn Kumie Simachew Amogne Debas Bantayehu Sileshi |
| author_facet | Amanuel Sisay Endeshaw Fantahun Tarekegn Kumie Simachew Amogne Debas Bantayehu Sileshi |
| author_sort | Amanuel Sisay Endeshaw |
| collection | DOAJ |
| description | Abstract Background Multimorbidity, particularly prevalent among older patients, represents a growing global health challenge. This study investigates the prevalence of multimorbidity and its relationship with perioperative outcomes among older patients undergoing major surgery in Ethiopia. Methods This longitudinal study was conducted at a tertiary teaching hospital in Northwest Ethiopia from June 01, 2019, to June 30, 2021. All consecutive older (aged 50+) patients who underwent major surgery during the study period were included. The primary outcome measure was estimating the prevalence of multimorbidity. Secondary outcome measures were the association between multimorbidity and 28-day perioperative mortality and length of hospital stay. A bivariable and multivariable modified Poisson regression was used to compute crude and adjusted relative risks, respectively, along with 95% confidence intervals (CIs) to assess the strength of association while adjusting for confounding covariates. A p-value < 0.05 was used to declare statistical significance. Results Of 874 patients who underwent major surgery, 234 (26.77%) patients had one comorbidity, and 94 (10.76%) patients had multimorbidity. Among all geriatric patients, 130 (14.87%) had hypertension, 34 (3.89%) had diabetes mellitus, and 29 (3.32%) had cancer. The most common multimorbidity combination was hypertension and diabetes (18 cases). The rates of perioperative mortality were higher in patients with multimorbidity compared with those with either one or no comorbidity (36.46% vs. 33.33% vs. 28.21%; p < 0.001). The risk of perioperative mortality after surgery among patients with multimorbidity was more than eight (adjusted relative risk = 8.07, 95% CI:2.39, 27.23) times higher than that of those with no comorbidity. Conclusion Multimorbidity in older surgical patients was common, and one in ten older patients undergoing major surgery had multimorbidity. Multimorbidity increases the risk of mortality among older patients following major surgery. We recommend targeted management of older surgical patients with multimorbidity by preoperative screening and optimization before surgery. |
| format | Article |
| id | doaj-art-32d4583f935948d09418fc58652f9ae3 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-32d4583f935948d09418fc58652f9ae32025-08-20T04:03:11ZengBMCBMC Public Health1471-24582025-08-0125111010.1186/s12889-025-24034-yPerioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from EthiopiaAmanuel Sisay Endeshaw0Fantahun Tarekegn Kumie1Simachew Amogne Debas2Bantayehu Sileshi3Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Anesthesia, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Anesthesia, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Anesthesiology, Vanderbilt University Medical CenterAbstract Background Multimorbidity, particularly prevalent among older patients, represents a growing global health challenge. This study investigates the prevalence of multimorbidity and its relationship with perioperative outcomes among older patients undergoing major surgery in Ethiopia. Methods This longitudinal study was conducted at a tertiary teaching hospital in Northwest Ethiopia from June 01, 2019, to June 30, 2021. All consecutive older (aged 50+) patients who underwent major surgery during the study period were included. The primary outcome measure was estimating the prevalence of multimorbidity. Secondary outcome measures were the association between multimorbidity and 28-day perioperative mortality and length of hospital stay. A bivariable and multivariable modified Poisson regression was used to compute crude and adjusted relative risks, respectively, along with 95% confidence intervals (CIs) to assess the strength of association while adjusting for confounding covariates. A p-value < 0.05 was used to declare statistical significance. Results Of 874 patients who underwent major surgery, 234 (26.77%) patients had one comorbidity, and 94 (10.76%) patients had multimorbidity. Among all geriatric patients, 130 (14.87%) had hypertension, 34 (3.89%) had diabetes mellitus, and 29 (3.32%) had cancer. The most common multimorbidity combination was hypertension and diabetes (18 cases). The rates of perioperative mortality were higher in patients with multimorbidity compared with those with either one or no comorbidity (36.46% vs. 33.33% vs. 28.21%; p < 0.001). The risk of perioperative mortality after surgery among patients with multimorbidity was more than eight (adjusted relative risk = 8.07, 95% CI:2.39, 27.23) times higher than that of those with no comorbidity. Conclusion Multimorbidity in older surgical patients was common, and one in ten older patients undergoing major surgery had multimorbidity. Multimorbidity increases the risk of mortality among older patients following major surgery. We recommend targeted management of older surgical patients with multimorbidity by preoperative screening and optimization before surgery.https://doi.org/10.1186/s12889-025-24034-yMultimorbidityGeriatricsPerioperative mortalitySurgeryEthiopia |
| spellingShingle | Amanuel Sisay Endeshaw Fantahun Tarekegn Kumie Simachew Amogne Debas Bantayehu Sileshi Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia BMC Public Health Multimorbidity Geriatrics Perioperative mortality Surgery Ethiopia |
| title | Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia |
| title_full | Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia |
| title_fullStr | Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia |
| title_full_unstemmed | Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia |
| title_short | Perioperative outcomes among older surgical patients with multimorbidity: a longitudinal study from Ethiopia |
| title_sort | perioperative outcomes among older surgical patients with multimorbidity a longitudinal study from ethiopia |
| topic | Multimorbidity Geriatrics Perioperative mortality Surgery Ethiopia |
| url | https://doi.org/10.1186/s12889-025-24034-y |
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