When patients develop complications after surgery, the term “failure to rescue” (FTR) is used to describe deaths that occur within 30 days or before hospital discharge. However, this traditional definition may miss deaths that happen later, when patients are still recovering but remain at risk.

This study, involving over 31,000 patients from 151 NHS hospitals, looked at ways to update and improve this measure. It found that many patients who experienced complications after major surgery remained at increased risk of death for up to four months after their operation—not just during their hospital stay.

By extending the definition of FTR to cover this longer period, the study was able to capture more deaths linked to postoperative complications. This “extended FTR” provides a more accurate picture of surgical risks and outcomes.

The research also developed a risk model using patient and surgical factors to predict who is most at risk of extended FTR. Importantly, the study found that differences between hospitals had little effect—suggesting the risks are more about patient factors than where surgery is performed.

This new approach could help the NHS better measure surgical quality and identify patients who might benefit from extra monitoring or support after leaving hospital, ultimately reducing avoidable deaths after surgery.

Lead Investigator

Ramani Moonesinghe