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Morbidity (from Latin morbidus, meaning sick, unhealthy) is a diseased state, disability, or poor health due to any cause [8]. Surgical morbidity relates to those morbid states that are related to a surgical procedure performed on a patient. Although traditionally defined by the presence or absence of specific postoperative complications, surgical morbidity represents any clinically significant, non‐fatal, adverse outcome associated with a surgical procedure [9]. Morbidity can be divided into local (associated with operation site, e.g. wound dehiscence) or general (related to any operation, e.g. acute renal failure). It can also be subdivided based on timely occurrence as intraoperative or postoperative; the latter being further considered as immediate, early, late or long‐term, although these are based on arbitrary time thresholds [9]. These categories overlap and are closely interconnected, as for example a specific, local complication such as surgical site infection may have general or systemic effects such as pyrexia, inappetence and motor dysfunction, which are not procedure specific [9].

Surgical mortality is any death regardless of cause, occurring: (1) within 30 days after surgery in or out of the hospital; or (2) after 30 days during the same hospitalization period subsequent to the operation [10, 11]. In patients undergoing more than one surgical procedure during a single hospitalization, mortality is assigned to the first operation during hospitalization [10].

In human medicine, postoperative morbidity has been shown to have a significant effect on mortality in patients undergoing major surgery; [12] however, the association between general postoperative morbidity and long‐term outcome or functionality is not well established [9]. This stems from the inconsistent reporting of morbidity in relation to definition, type and criteria, which leads to a lack of reliability in the recording of complications data [9]. Surgical mortality is a concrete universal outcome measure, but unlike morbidity, mortality recording has traditionally been inconsistent as a result of variable duration of hospitalization, follow‐up information, and number of surgical procedures performed during the same hospitalization period or different hospitalization periods [10].

Evidence‐based knowledge on complications has rapidly evolved and continues to do so in human medicine. The Morbidity and Mortality Conferences (MMCs) were established in the beginning of the 20th century at the Massachusetts General Hospital in Boston [13], with the aim to improve the quality and safety of human healthcare [14]. The MMCs have become a requirement for all human medicine surgical training programs in high‐risk specialties such as surgery, anesthesia, intensive care and oncology, being a key factor in the accreditation of human hospitals [15]. These conferences are associated with improvements in healthcare quality and patient safety through analysis of failures [15]. To further improve the effectiveness of these MMCs, additional structured frameworks such as the Physician Peer Review have been implemented, enabling surgeons to review and evaluate peer surgeons’ results and take corrective actions [16, 17]. These systems aim to improve competencies, protect patients from harm and assist institutions in their evaluations of surgical outcomes, with the ultimate goal of improvement of patient outcome through implementation of measures to identify and prevent operative complications.

In 1991, Copeland et al. developed the “Physiological and Operative Severity Score for the numeration of Mortality and morbidity (POSSUM)” as a representative method for evaluating the result of surgery in patients [18]. This system includes a physiological score and an operation severity score to calculate individual risk for morbidity and mortality. Classification systems for perioperative complications (such as the Clavien–Dindo classification) have been developed [19] and application of these systems has confirmed their prediction of morbidity and mortality rates in humans [20]. Over the last few years, equine studies have focused on identification of prognostic factors, mainly associated with mortality, in patients suffering from certain conditions or undergoing specific surgical procedures. From those studies, risks factors have been identified which provide useful information during the decision‐making process between veterinarian and horse owner. However, inconsistent definitions, limited populations and diverse management regimes often limit universal conclusions. Adaptations of POSSUM‐like strategies to the equine surgical field warrant consideration.