冈珀茨-马克汉姆定律描述了人类死亡率的一种特征模式，其中死亡率在 18 岁至 30 岁之间几乎保持不变（马克汉姆定律），此后呈指数上升（冈佩茨定律）。这种模式尚未在手术人群中得到描述，但如果属实，将对理解手术风险以及手术风险模型的设计和解释产生重要影响。本研究的目的是确定 Gompertz-Makeham 定律是否适用于围手术期死亡风险以及适用的条件。我们在一项为期 10 年的新研究中研究了年龄与术后 1 个月全因死亡风险之间的关系。新西兰行政数据集包含 2007 年至 2016 年 5,615,100 例外科手术。该数据集包括患者和手术因素，包括手术、美国麻醉师协会的身体状况评分 (ASA-PS)、诊断和其他相关详细信息。绘制了死亡风险和年龄的半对数图。拟合线性回归模型，计算回归线斜率和皮尔逊相关系数。主要结局发生在 5,615,100 名参与者中的 114,782 名（2.0%）。 Gompertz-Makeham 定律似乎适用于整个全国手术人群（斜率 = 0.0241，R2 = 0.971）。该定律适用于所有研究的亚组，包括性别、ASA-PS、手术敏锐度、手术严重程度类别、癌症状况和种族（斜率 0.0066 至 0.0307，R2 0.771 至 0.990）。在年龄、死亡风险和三个高风险群体（癌症诊断、ASA-PS 4-5 和高手术严重程度）之间发现了重要的相互作用。Gompertz-Makeham 定律似乎适用于全国手术患者队列。 1 个月风险增加的拐点在 30 岁时就很明显。此后死亡风险出现严格的指数上升。这一发现提高了我们对手术风险的理解，并提出了一种概念驱动的方法来改进未来手术风险模型中年龄和重要相互作用的建模。版权所有 © 2024 美国麻醉医师协会。版权所有。

The Gompertz-Makeham law describes a characteristic pattern of mortality in human populations where death rate is near constant between age 18 and 30 years (Makeham's Law) and rises exponentially thereafter (Gompertz Law). This pattern has not been described in surgical populations, but if true, would have important implications for understanding surgical risk and design and interpretation of surgical risk models. The aim of this study was to determine if the Gompertz-Makeham law applies to perioperative mortality risk and the conditions under which it may apply.We examined the relationship between age and 1-month postoperative all-cause mortality risk in a 10-year New Zealand administrative dataset comprising of 5,615,100 surgical procedures from 2007 to 2016. The dataset includes patient and surgical factors including procedures, American Society of Anesthesiologist's physical status score (ASA-PS), diagnoses and other relevant details. Semi-logarithmic graphs of mortality risk and age were plotted. Linear regression models were fitted, with regression line slope and Pearson's correlation coefficient calculated.The primary outcome occurred in 114,782 (2.0%) of 5,615,100 included participants. The Gompertz-Makeham law seems to apply to the national surgical population as a whole (slope = 0.0241, R2 = 0.971). The law applies in all subgroups studied including sex, ASA-PS, surgical acuity, surgical severity category, cancer status and ethnicity (slopes 0.0066 to 0.0307, R2 0.771 to 0.990). Important interactions were found between age, mortality risk and three high risk groups (cancer diagnosis, ASA-PS 4-5 and high surgical severity).The Gompertz-Makeham law seems to apply in a national cohort of surgical patients. The inflection point for increased 1-month risk is apparent at age 30 years. A strict exponential rise in mortality risk occurs thereafter. This finding improves our understanding of surgical risk and suggests a concept-driven approach to improve modelling of age and important interactions in future surgical risk models.Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved.