{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:16:12Z","timestamp":1791249372488,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a pre\u2010planned analysis of a prospective, multicentre, international study investigating cardiovascular complications after major abdominal surgery conducted in 446 hospitals in 29 countries across Europe. The primary outcome was 30\u2010day postoperative mortality. The secondary outcome measure was the incidence of complications within 30\u2009days of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 24,227 patients, 7006 (28.9%) had one long\u2010term condition and 10,486 (43.9%) had multimorbidity (two or more long\u2010term health conditions). The most common conditions were primary cancer (39.6%); hypertension (37.9%); chronic kidney disease (17.4%); and diabetes (15.4%). Patients with multimorbidity had a higher incidence of frailty compared with patients \u2264\u20091 long\u2010term health condition. Mortality was higher in patients with one long\u2010term health condition (adjusted odds ratio 1.93 (95%CI 1.16\u20133.23)) and multimorbidity (adjusted odds ratio 2.22 (95%CI 1.35\u20133.64)). Frailty and ASA physical status 3\u20135 mediated an estimated 31.7% of the 30\u2010day mortality in patients with one long\u2010term health condition (adjusted odds ratio 1.30 (95%CI 1.12\u20131.51)) and an estimated 36.9% of the 30\u2010day mortality in patients with multimorbidity (adjusted odds ratio 1.61 (95%CI 1.36\u20131.91)). There was no improvement in 30\u2010day mortality in patients with multimorbidity who received pre\u2010operative medical assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multimorbidity is common and outcomes are poor among surgical patients across Europe. Addressing multimorbidity in elective and emergency patients requires innovative strategies to account for frailty and disease control. The development of such strategies, that integrate care targeting whole surgical pathways to strengthen current systems, is urgently needed for multimorbid patients. Interventional trials are warranted to determine the effectiveness of targeted management for surgical patients with multimorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16324","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T05:00:16Z","timestamp":1716786016000},"page":"945-956","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe"],"prefix":"10.1111","volume":"79","author":[{"name":"STARSurg Collaborative","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EuroSurg Collaborative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization.Multimorbidity: Technical Series on Safer Primary Care: Multimorbidity.2016.https:\/\/www.who.int\/publications\/i\/item\/9789241511650."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(23)00277\u20102"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afx201"},{"key":"e_1_2_6_5_1","unstructured":"WhittyCM Department of Health and Social Care.Chief Medical Officer's annual report 2023: health in an ageing society. 2023.https:\/\/assets.publishing.service.gov.uk\/media\/65562ff2d03a8d000d07faa6\/chief\u2010medical\u2010officers\u2010annual\u2010report\u20102023\u2010web\u2010accessible.pdf."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X713897"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010057017"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010021\u201001817\u2010z"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(15)70115\u20104"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11148"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589\u20107500(19)30012\u20103"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102018\u2010021784"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102015\u2010010126"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10186"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.01.542"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.190221"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.02.012"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed\u20102022\u2010000247"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e318281a64e"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2023.04.041"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000947"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew316"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly110"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2020.01.021"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15682"},{"key":"e_1_2_6_29_1","unstructured":"Academy of Medical Sciences.Multimorbidity: a priority for global health research. 2018.https:\/\/acmedsci.ac.uk\/file\u2010download\/82222577."}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.16324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T19:00:48Z","timestamp":1761678048000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.16324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,27]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/anae.16324"],"URL":"https:\/\/doi.org\/10.1111\/anae.16324","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,27]]},"assertion":[{"value":"2024-04-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}