title: Mortality after peripheral bypass surgery: value of a mortality scoring system in evaluating the quality of care.
abstract: The objective of this study was to determine the role of a mortality registration in the quality control of patients who died after peripheral bypass surgery. We developed a mortality registration to classify causes of death, to evaluate shortcomings in treatment, and to determine the extent of agreement between pre- and postmortem findings. In a 10-year period, 28 of the 1,022 patients (2.7%) who underwent peripheral arterial reconstruction died. Fifty-three percent of the patients died owing to postoperative complications, most frequently a myocardial infarction. A shortcoming in the medical treatment was observed in only one patient. Forty-three percent of the relatives gave permission for an autopsy. In only two cases, the autopsy report revealed a myocardial infarction that had remained unnoticed during the clinical course. In this selected group of patients undergoing a peripheral bypass operation, the causes of death and the shortcomings in medical care could usually be identified without the help of autopsy data.
authors.affiliation: Department of Surgery, Red Cross Hospital, The Hague, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Klinkert
authors.forename: Tim J
authors.initials: TJ
authors.lastname: van der Steenhoven
authors.forename: Mark-Paul F M
authors.initials: MP
authors.lastname: Vrancken Peeters
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Breslau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009426:Netherlands; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods*; D011786:Quality Control; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000401:mortality* / Q000592:standards