watters-nationalsurgicalmortality-2017.pdf (370.46 kB)
National surgical mortality audit may be associated with reduced mortality after emergency admission
journal contribution
posted on 2017-10-01, 00:00 authored by A Kiermeier, W J Babidge, G A J McCulloch, G J Maddern, David WattersDavid Watters, R J AitkenBackground: The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. Method: The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 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.
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.
History
Journal
ANZ Journal of SurgeryVolume
87Issue
10Pagination
830 - 836Publisher
Wiley-Blackwell Publishing AsiaLocation
Melbourne, Vic.Publisher DOI
Link to full text
ISSN
1445-1433eISSN
1445-2197Language
engPublication classification
C Journal article; C1.1 Refereed article in a scholarly journalCopyright notice
2017, Royal Australasian College of SurgeonsUsage metrics
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