The Risk of Death From Surgery

If you are considering surgery there is always a risk of death due to the procedure or anesthesia that is given during the procedure. This is true of outpatient procedures and inpatient procedures, even if the surgery is an optional procedure, such as cosmetic plastic surgery

While there is always a risk of death, this risk varies widely between types of surgeries and patients. This is why surgery should never be taken lightly; the possibility of death is very real, even with minor dental procedures.

Some surgeries have a much higher risk level than others. However, it is very rare for a healthy individual to die during a minor dental procedure. Other procedures are a much higher risk. 

For example, during some open heart surgeries, the heart is actually stopped for almost an hour before being restarted. That surgery has a higher risk than carpal tunnel surgery, which is performed on a patient’s hand and wrist, often in an outpatient surgery center.

Your Health History

Your personal health history, age, weight, family health history, and general state of health will directly impact your personal level of risk when having surgery. Your risk factors include things you can modify and those you can't.

Modifiable risk factors include:

• Smoking
• Physical activity
• Excess weight
• Compliance with medication and pre-surgical preparation
• Use of alcohol or controlled substances
• Management of underlying conditions, such as high blood pressure or high blood sugar

Other factors you can't modify include:

• Age
• Coronary artery disease
• Diabetes
• Chronic obstructive pulmonary disease (COPD)
• Cancer
• Other chronic diseases
  

The Surgery and the Surgeon

The type of surgery being performed plays a huge role in how high the risk of death will be.

In general, urgent or emergency surgery carries the highest risk. This may occur with trauma, such as a car accident, after a serious medical event (such as cardiac arrest or ruptured aortic aneurysm), for appendicitis or gallbladder disease, or repairs to the bowels.

Elective surgery has a lower risk. This can include weight loss surgery, inguinal hernia repair, partial mastectomy, or cosmetic plastic surgery.

One study of 2,800,069 hospital surgical admissions in Poland found these types of surgeries the most at risk for death after surgery:

• Injuries
• Neurosurgery
• Gastrointestinal tract surgery (laparotomy, peptic ulcer disease repair, small bowel resection, partial colectomy, lysis of adhesions, appendectomy)
• Respiratory system surgery

Medium risk was seen in these types of surgery:

• Liver, biliary tract, pancreas, spleen
• Heart and circulatory system
• Endocrinological
• Skin and mammary gland
• Bones and muscles
• Head and neck
• Urinary tract

Lower risk was seen for surgery involving:

• Female genital tract
• Eye surgery

The skill and experience of the surgeon and the surgical center are also a factor in surgical outcomes.

Anesthesia

If you have had issues with anesthesia in the past, you are more likely to have complications with anesthesia during any future procedures. In some cases, you are more likely to have anesthesia issues if a close family member has had issues. Having obstructive sleep apnea also increases risks from general anesthesia.

Complications of anesthesia include aspiration during induction, loss of airway or difficult intubation, and opiate-induced respiratory depression.

One serious reaction to anesthesia, malignant hyperthermia, is genetic and causes the patient to have a very high fever along with other issues when exposed to anesthesia. The skill of the anesthesia provider also plays a role in your level of risk. 

It is also important to know that deaths during and immediately after surgery are usually a result of a reaction to anesthesia rather than an issue with the surgical procedure itself.

Understanding Your Risk

If you're considering surgery, ask your surgeon about the risk of death during the procedure you are planning. Your healthcare provider will take your personal health into account along with the typical risks of the procedure to estimate your risk level.

It is not unreasonable to ask for your risk as a number, as in "there's a 5% risk of death during this procedure."

The American College of Surgeons created a Surgical Risk Calculator that takes functional status, medical history, body mass index (BMI), age, and smoking status, among other variables, into account to determine level of surgical risk.

Discuss your concerns with your surgeon and find out what kind of risk is involved in the surgery you need.

A Word From Verywell

Understanding your surgical risk and why your risk level is what it is can be very helpful when preparing for surgery because it can allow you to take action to reduce that risk before the procedure happens. 

For example, stopping smoking before surgery can dramatically reduce the chances of being on a ventilator for a prolonged period of time, and getting glucose levels under control can dramatically improve the outcome for diabetics.