Perioperative Mortality Rates in Australian Public Hospitals: The Influence of Age, Gender and Urgency

Watters, David; Babidge, Wendy; Kiermeier, Andreas; McCulloch, Glenn A. J.; Maddern, Guy J.

doi:10.1007/s00268-016-3587-x

Cited by 23 publications

(25 citation statements)

References 22 publications

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“…This study provides greater detail than an earlier report that only considered Australian public hospitals. 26 For example, ophthalmology and obstetrics had 96 deaths, but the number of procedures (3.743 million) was slightly greater than orthopaedics (3.591 million), a high-risk specialty with 7851 deaths -a 85-fold difference. Endoscopy was included as it is an important component of surgical work.…”

Section: Discussionmentioning

confidence: 99%

National surgical mortality audit may be associated with reduced mortality after emergency admission

Kiermeier¹,

Babidge

McCulloch

et al. 2017

ANZ Journal of Surgery

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was used to assess changes in surgical mortality. Results: Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P < 0.0001). A similar decrease was seen in all regions. The mortality reduction was overwhelmingly observed in elderly patients admitted as an emergency. Conclusion: The commencement of this nation-wide mortality audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes.

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Section: Discussionmentioning

confidence: 99%

National surgical mortality audit may be associated with reduced mortality after emergency admission

Kiermeier¹,

Babidge

McCulloch

et al. 2017

ANZ Journal of Surgery

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“…Improvements in decision making, leadership, communication and documentation, preoperative management, postoperative management, establishing appropriate care and acting upon it, issues of shared care are all components of care identified in previous VASM publications and have been repeatedly reported in successive case note review booklets – a recurrent theme involves the substandard management of the deteriorating patient as a preventable issue . Despite the clinical management challenges identified in surgical patients, the mortality rate has decreased over time …”

Section: Discussionmentioning

confidence: 99%

“…18 Despite the clinical management challenges identified in surgical patients, the mortality rate has decreased over time. 19,20 Assessor grade This paper shows that although there is excellent concordance in determining preventable deaths between the treating surgeon and the FLA, this is not apparent between the FLA and SLA. This is not surprising as the FLA is influenced by the details submitted by the treating surgeon, whereas the SLA has access to the patient records.…”

Section: General Management Issuesmentioning

confidence: 95%

Potentially preventable deaths in the Victorian Audit of Surgical Mortality

Chen

Retegan

Vinluan

et al. 2016

ANZ Journal of Surgery

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“…Australia's surgical mortality rate between 2009 and 2013 was low after both emergency (1 per cent) and elective (less than 1 per cent) surgery. This is reflected in the QASM data set, which included 9705 patients between 2007 and 2017.…”

Section: Resultsmentioning

confidence: 99%

Learning from regret

Boyle¹,

Allen

Rey-Conde

et al. 2020

British Journal of Surgery

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Background Death after surgery is infrequent but can be devastating for the surgeon. Surgeons may experience intense emotional reactions after a patient's death, reflecting on their part in the death and the patient's loss of life. Excessive rumination or feelings of regret may have lasting negative consequences, but these reactions may also facilitate learning for future decision‐making. This qualitative study analysed surgeons' reflections on what might have been done differently before a patient's death and explored non‐technical (cognitive and interpersonal) aspects of care as potential targets for improvement. Methods In Australia's Queensland Audit of Surgical Mortality, surgeons reflect on factors surrounding the death of patients in their care and respond to the open‐ended question: in retrospect, would you have done anything differently? Framework analysis was applied to surgeons' responses to identify themes relating to non‐technical aspects of care. Results Responses from 1214 surgeons were analysed. Two main themes were identified. Dilemmas and difficult decisions confirmed the uncertainty, complexity and situational pressures that often precede a surgical death; regret and empathy for patients featured in some responses. In the second main theme, communication matters, surgeons cited better communication, with patients, families, colleagues and at handover, as a source of reflective change to improve decision‐making and reduce regret. Conclusion Surgical decision‐making involves uncertainty, and regret may occur after a patient's death. Enhancing the quality of communication with patients and peers in comprehensive assessment of the surgical patient may mitigate postdecision regret among surgeons.

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Perioperative Mortality Rates in Australian Public Hospitals: The Influence of Age, Gender and Urgency

Cited by 23 publications

References 22 publications

National surgical mortality audit may be associated with reduced mortality after emergency admission

National surgical mortality audit may be associated with reduced mortality after emergency admission

Potentially preventable deaths in the Victorian Audit of Surgical Mortality

Learning from regret

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