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

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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 Aitken
Background: 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.

History

Journal

ANZ Journal of Surgery

Volume

87

Issue

10

Pagination

830 - 836

Publisher

Wiley-Blackwell Publishing Asia

Location

Melbourne, Vic.

ISSN

1445-1433

eISSN

1445-2197

Language

eng

Publication classification

C Journal article; C1.1 Refereed article in a scholarly journal

Copyright notice

2017, Royal Australasian College of Surgeons

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