Systematic review of the quality of surgical mortality monitoring

Author:

Russell E M1,Bruce J1,Krukowski Z H2

Affiliation:

1. Department of Public Health, University of Aberdeen, Medical School, Polwarth Building, Aberdeen AB25 2ZD, UK

2. Department of Surgery, University of Aberdeen, Medical School, Polwarth Building, Aberdeen AB25 2ZD, UK

Abstract

Abstract Background Mortality is the most tightly defined and used adverse event for audit and performance monitoring in surgery. However, to identify cause and therefore scope for improvement, accurate and timely data are required. The aim of this study was to perform a systematic review of the quality of measurement, reporting and monitoring of mortality as an outcome after surgery. Methods A systematic review of published literature was undertaken for the 7-year interval 1993–1999. Grey and unpublished literature was obtained through the Royal College of Surgeons of England, from UK national audits and routine national hospital data collections. Results Eligible monitoring systems included six UK national surgical audits, and cardiac and vascular surgery monitoring systems from North America and the UK. The definitions of ‘surgical death’ varied in several respects and deaths after discharge from hospital were rarely ascertained unless there was routine linkage to national death registers. There were very few published studies on validation of the completeness and accuracy of the data collection. Conclusion A comprehensive data collection system is needed for improving clinical performance, with ownership, but not necessarily data collection, resting with the surgeons concerned. Recording of risk factors and deaths after discharge from hospital is essential, whatever data collection system is used.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference38 articles.

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2. Operative mortality with elective surgery in older adults;Finlayson;Eff Clin Pract,2001

3. The development of The Society of Thoracic Surgeons voluntary national database system: genesis, issues, growth, and status;Clark;Best Pract Benchmarking Healthc,1996

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