The Scottish Audit of Surgical Mortality: a review of areas of concern related to anaesthesia over 10 years.
The Scottish Audit of Surgical Mortality is a voluntary, peer reviewed, critical event analysis of patients who die under the care of consultant surgeons in acute hospitals in Scotland. The anaesthetic contribution to surgical mortality over a 10-year period from 1996 was reviewed. The total number of deaths was 44 230 or 1.5% of all admissions. Forty thousand, eight hundred and ninety-six deaths (92%) were audited. Deaths after elective surgery declined over 10 years. Over 80% of deaths followed emergency admission. The number of deaths where an anaesthetist was present was 16 981 or 0.6% of all admissions. Anaesthetic areas of concern were identified in 8% of deaths. Of these, 43% were related to pre-operative assessment. Anaesthesia also played a part in a further 18% of deaths where decision making was shared with the surgical team. Of these, 41% were related to access to critical care. A further 24% related to communication failures, principally when the operation should not have been done or was unnecessary.
Aberdeen Royal Infirmary, Aberdeen, Scotland. harry.mcfarlane@nhs.net
H J
HJ
McFarlane
N
N
van der Horst
L
L
Kerr
G
G
McPhillips
H
H
Burton
D000758:Anesthesia / Q000401:mortality* / Q000592:standards; D002983:Clinical Competence; D017558:Elective Surgical Procedures / Q000401:mortality; D004630:Emergencies; D006302:Health Services Research / Q000379:methods; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008485:Medical Audit; D011300:Preoperative Care / Q000592:standards; D012606:Scotland / Q000453:epidemiology; D013514:Surgical Procedures, Operative / Q000401:mortality* / Q000592:standards