Perioperative mortality rates in Australian public hospitals : the influence of age, gender and urgency

Watters, David A, Babidge, Wendy J, Kiermeier, Andreas, McCulloch, Glenn AJ and Maddern, Guy J 2016, Perioperative mortality rates in Australian public hospitals : the influence of age, gender and urgency, World journal of surgery, vol. 40, no. 11, pp. 2591-2597, doi: 10.1007/s00268-016-3587-x.

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Title Perioperative mortality rates in Australian public hospitals : the influence of age, gender and urgency
Author(s) Watters, David AORCID iD for Watters, David A
Babidge, Wendy J
Kiermeier, Andreas
McCulloch, Glenn AJ
Maddern, Guy J
Journal name World journal of surgery
Volume number 40
Issue number 11
Start page 2591
End page 2597
Total pages 7
Publisher Springer
Place of publication Berlin, Germany
Publication date 2016-11
ISSN 1432-2323
Summary INTRODUCTION: A decline in surgical deaths has been observed in Australia since the introduction of the Australian and New Zealand Audit of Surgical Mortality (ANZASM). The current study was conducted to determine whether the perioperative mortality rate (POMR) has also declined. METHODS: This study is a retrospective review of the POMR for surgical procedures in Australian public hospitals between July 2009 and June 2013, using data obtained from the Australian Institute of Health and Welfare. Operative procedures contained in the Australian Refined Diagnosis Related Groups were selected and the POMR was modelled using urgency of admission, age and gender as explanatory covariates. RESULTS: The POMR in Australian public hospitals reduced by 15.4 % over the 4-year period. The emergency admissions POMR dropped from 1.40 to 1.12 %, and the elective admissions POMR from 0.09 to 0.08 %. The binary logistic regression model used to predict patient mortality showed emergency admissions to have a higher POMR than elective, being more evident at older ages. For emergency admissions, the difference in POMR between females and males increased with age, from about 55 years onwards, with females being lower. For elective surgeries, the difference between males and females was of little practical importance across ages. CONCLUSIONS: The reduction in the POMR in Australia confirms the reduction in surgical deaths reported to ANZASM. Continuing to monitor POMR will be important to ensure the safest surgery in Australia. Further investigations into case-mix will allow better risk adjustment and comparison between regions and time-periods, to facilitate continuous quality improvement.
Language eng
DOI 10.1007/s00268-016-3587-x
Field of Research 111799 Public Health and Health Services not elsewhere classified
1103 Clinical Sciences
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Societe Internationale de Chirurgie
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