Long-term outcomes after perioperative and intensive care

Our research focuses on morbidity and mortality after major surgery and critical illness.

Around 50 000 patients are treated in Intensive Care Units and more than 800 000 patients undergo surgery and anesthesia in Sweden every year. With perioperative and intensive care offered to an elder and comorbid population complications increase, contributing to long-term morbidity. In the perioperative setting complications increase risk of death five-fold. Perioperative death, within 30 days following surgery, has been reported to be the 3rd leading cause of mortality, exceeded only by heart disease and cancer.

We have multiple ongoing projects regarding long-term mortality and morbidity after perioperative care; focusing on myocardial injury and -infarction, acute kidney injury as well as cognitive dysfunction and stroke. We are investigating intraoperative hypotension and other modifiable factors. For future interventional trials to be effective it is essential to focus on the right patients, those with the highest risk of adverse events; can we describe these at-risk-individuals? What are the perioperative risks of stroke, pneumonia and acute kidney injury? We also study potential effects of wireless monitoring of high-risk patients in the postoperative and post intensive care setting.

With regards to critical illness and multiorgan failure, we investigate the impact of acute kidney injury (AKI) and study both kidney injury biomarkers- and functional biomarkers and their association with long-term outcomes. Is it possible to detect patients at risk for further renal deterioration and can interventional programs minimize that risk?  

Group member

Max Bell

Senior physician, Research group leader

Linn Hallqvist

Affiliated to research

Bo Ravn

Affiliated to research

Daniel Hertzberg

Affiliated to research

Claire Rimes-Stigare


Ellen Leigard

PhD student

Fredrik Granath

Lecturer senior

Research support

  • Innovationsfonden, SLL
  • Stockholm County Council
  • Hjärt-Lung-fonden
  • Baxter Medical

Selected publications

Intraoperative Hypotension and Myocardial Infarction Development Among High-Risk Patients Undergoing Noncardiac Surgery: A Nested Case-Control Study.
Hallqvist L, Granath F, Fored M, Bell M
Anesth Analg 2021 Feb;():

Renal resistive index is associated with acute kidney injury in COVID-19 patients treated in the intensive care unit.
Renberg M, Jonmarker O, Kilhamn N, Rimes-Stigare C, Bell M, Hertzberg D
Ultrasound J 2021 Feb;13(1):3

Biomarker-guided management of acute kidney injury.
Kane-Gill SL, Meersch M, Bell M
Curr Opin Crit Care 2020 12;26(6):556-562

Heart Failure in Patients Undergoing Elective and Emergency Noncardiac Surgery: Still a Poorly Addressed Risk Factor.
Faxén UL, Hallqvist L, Benson L, Schrage B, Lund LH, Bell M
J Card Fail 2020 Dec;26(12):1034-1042

Feasibility of renal resistive index measurements performed by an intermediate and novice sonographer in a volunteer population.
Renberg M, Kilhamn N, Lund K, Hertzberg D, Rimes-Stigare C, Bell M
Ultrasound J 2020 May;12(1):28

Myocardial infarction after noncardiac surgery in Sweden: a national, retrospective observational cohort study.
Hallqvist L, Granath F, Bell M
Br J Anaesth 2020 07;125(1):47-54

The impact of patient sex on intensive care unit admission: a blinded randomized survey.
Zettersten E, Jäderling G, Larsson E, Bell M
Sci Rep 2019 10;9(1):14222

Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance.
Bell M, Eriksson LI, Svensson T, Hallqvist L, Granath F, Reilly J, Myles PS
EClinicalMedicine ;11():18-26

Creatinine- and Cystatin C-Based Incidence of Chronic Kidney Disease and Acute Kidney Disease in AKI Survivors.
Rimes-Stigare C, Ravn B, Awad A, Torlén K, Martling CR, Bottai M, Mårtensson J, Bell M
Crit Care Res Pract 2018 ;2018():7698090

Intraoperative hypotension is associated with acute kidney injury in noncardiac surgery: An observational study.
Hallqvist L, Granath F, Huldt E, Bell M
Eur J Anaesthesiol 2018 04;35(4):273-279

Superiority of Serum Cystatin C Over Creatinine in Prediction of Long-Term Prognosis at Discharge From ICU.
Ravn B, Prowle JR, Mårtensson J, Martling CR, Bell M
Crit Care Med 2017 Sep;45(9):e932-e940


Max Bell

Lecturer/senior physician