COIOS
Healthcare today Item refines peer-reviewed

Pairs of conditions carry mortality beyond the sum of their separate effects

Among 61,400 Danish adults having major emergency abdominal surgery between 2002 and 2022, mortality was 11% at seven days and 31% at one year, and several comorbidity pairs were associated with excess mortality beyond their effects in isolation.

A nationwide Danish register cohort followed all 61,400 adults who had major emergency abdominal surgery between 2002 and 2022, measuring mortality at 7, 90 and 365 days. Liver disease had the strongest association with death within seven days (OR 2.75), while metastatic malignant disease dominated later mortality (OR 9.37 between 91 and 365 days). Regression identified combinations involving cardiac, renal, liver and cerebrovascular disease whose joint association with death exceeded the sum of the separate associations.

Why it is interesting: It tests the assumption of independence between conditions that underlies the comorbidity indices used throughout risk stratification.

Source
Journal of Trauma and Acute Care Surgery, 22 September 2026
DOI
10.1097/ta.0000000000005168
Type
Peer-reviewed article
Design
Nationwide register-based cohort, all adults undergoing major emergency abdominal surgery in Denmark 2002-2022, n=61,400, with LASSO regression for comorbidity interactions
Verdict
Refines prior evidence
Driver
Frailty and multimorbidity