Authors: Xu Zhao et al.
BMC Anesthesiology 25: 407, 2025. doi:10.1186/s12871-025-03046-2
This retrospective cohort study examined the impact of multimorbidity (≥2 chronic conditions) on postoperative outcomes among 37,084 adult patients undergoing non-cardiac surgery in China in 2023. Patients were stratified into three groups: no morbidity, one morbidity, or multimorbidity. Outcomes included in-hospital mortality, hospital stay, and hospitalization costs.
Multimorbidity was present in 17.4% of surgical patients. These individuals experienced substantially higher risks: mortality was 1.5% compared with 0.7% for those with one morbidity and 0.2% with none. Hospital stays were extended (median 8 vs 7 vs 6 days), and costs were markedly higher ($6,485 vs $4,975 vs $3,714). Regression analysis confirmed multimorbidity independently predicted higher mortality, longer hospital stays, and increased costs. The highest mortality risk and cost burden occurred in patients with hypertension combined with chronic kidney disease and anemia.
Overall, multimorbidity was associated with a 2–7 fold higher mortality, longer hospitalizations, and significantly higher financial burden, underscoring the importance of individualized preoperative assessment and perioperative management strategies in this growing population.
What you should know:
-
Multimorbidity affects nearly 1 in 5 surgical patients in China.
-
Mortality risk increases sharply with multimorbidity compared to single or no morbidity.
-
Hospital stays and costs also rise significantly, adding 1–2 days and ~$1,500–$2,700 per patient.
-
Certain disease combinations, especially hypertension with kidney disease and anemia, carry the highest risk and cost burden.
-
Findings support strengthening preoperative evaluation and tailored perioperative care for multimorbid patients.
Thank you to BMC Anesthesiology for publishing this large-scale analysis on surgical outcomes in multimorbid patients.