title: Reduction in gastric cancer surgical mortality over 10 years: An adverse events analysis.
abstract: BACKGROUND
  The reduction in gastric cancer mortality is due to a reduction in incidence and of surgical mortality. This study was to examine adverse events in patients with gastric cancer dying under surgical care.
  
  
  METHODS
  Adverse events in surgical care were prospectively audited in patients who died of gastric cancer in Scottish hospitals. A cohort retrospective study examining deaths and contributing adverse events was compared for the periods 1996-2000 and 2001-2005.
  
  
  RESULTS
  Between 1996 and 2005, 1083 patients with gastric cancer died on surgical wards in Scottish hospitals. The annual number of deaths under surgical care fell significantly from an average of 128 deaths per annum in years 1996-2000 to 88 deaths per annum in 2001-2005 (p < 0.001). This occurred in parallel with the decline in gastric cancer incidence over the same period. There was an increase in the proportion of gastric cancer resections carried out in 7 major hospitals in Scotland in the second period of the study (p < 0.001). The mean number of deaths in the group of patients, who had gastric cancer resection and palliative surgery, were significantly lower in the second period of the study In addition, when all patients were considered as a group, the mean number of anaesthetic, critical care, medical management and technical surgery adverse events were significantly lower in the second study period.
  
  
  CONCLUSIONS
  There has been a reduction in deaths and adverse events for patients with gastric cancer under surgical care and this has been associated with surgical subspecialisation in oesophago-gastric cancer surgery.
authors.affiliation: Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom.
authors.forename: J A
authors.initials: JA
authors.lastname: Young
authors.affiliation: Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom.
authors.forename: S M
authors.initials: SM
authors.lastname: Shimi
authors.affiliation: Scottish Audit of Surgical Mortality, Cirrus Building, Marchburn Drive, Paisley PA3 2SJ, United Kingdom.
authors.forename: L
authors.initials: L
authors.lastname: Kerr
authors.affiliation: Scottish Audit of Surgical Mortality, Cirrus Building, Marchburn Drive, Paisley PA3 2SJ, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: McPhillips
authors.affiliation: Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom ; Scottish Audit of Surgical Mortality, Cirrus Building, Marchburn Drive, Paisley PA3 2SJ, United Kingdom.
authors.forename: A M
authors.initials: AM
authors.lastname: Thompson
keywords: Adverse events; Gastric cancer; Hospital volume; Mortality; Scotland; Surgery