Deaths during Operations and in the Postoperative Period: 155 260 Anaesthetics Administeredin Motol University Hospital Prague during 1999–2003

Overview

Objective:
Analysis of the deaths during operations – mors in tabula – during 1999–2003 and evaluation of the deaths during24 hours following anaesthesia during 2000–2003.Design: Retrospective observational study.Setting:Department of Anaesthesiology and Intensive Care Medicine of Charles University, 2th Medical Faculty and Institutefor Further of Health Professionals in University Hospital, Prague-Motol.Material and Method:The database of complicationwas used to supply demographic data, theASAclass,type of anaesthesiaand character of the operation (elective or urgent). Peroperative mortality, mortality during 24 hours after anaesthesia andoverall perioperative mortality expressed in %, deaths per 10000 anaesthetics and number of anaesthetics per 1 death wereestablished. Mortality during operation where the anaesthetic management was found responsible or contributory wasevaluated. Data were expressed as a mean ± standard deviation where appropriate. For statistical evaluation χ2 test withYates’ correction was used, α = 0.05.Results: 155 260 anaesthetics was administered during 1999–2003. There were 31 deaths during operations all occuringunder general anaesthesia. Peroperative mortality was 1.996 deaths per 10 000 operations (~0.02%; 1 death per 5000operations). Two deaths attributable to the anaesthetic management were found contributing to 6.5% of all peroperativedeaths (0.0013% of all operations, 1 per 77 630 operations or 0.13 deaths per 10 000 operations).ASA class was preoperatively established in 24 deceased (77%), there was either ASA IV or V in 22 deceased. Out of 31deaths 21 (68%) occured during urgent operations (P < 0.000005).Traumatology (39%), cardiac and general surgery (23% each) were specialties where the deaths occured more frequently.96563 patients were operated upon during 2000,2002–2003. Mortality within 24 hours of operation was 49 (0.05%,5.1 deathsper 10000 operations, deaths per 1971 operations). Overall perioperative mortality was 76 (0.08%, 7.9 deaths per 10000operations, 1 death per 1270 operations).Conclusion: Peroperative mortality during 1999–2003 was 2 per 10 000 operations.Good correlation with the high ASA classwas ascertained as well as a higher risk of urgent procedures. Anaesthesia contributed to 6.5% of all peroperative deaths(0.0013% of all operations, 1 death per 77 630 operations, 0.13 death per 10 000 operations).The postoperative mortality within 24 hours (probably underestimated) was 0.05%, 5.1 deaths per 10 000 operations or 1death per 1971 operations. The overall perioperative mortality was 0.08%, 7.9 deaths per 10 000 operations or 1 death per1270 operations.

Key words:
anaesthesia – complications – mortality