Building a large-scale perioperative anaesthesia outcome-tracking database: methodology, implementation, and experiences from one provider within the German quality project.

The German Society of Anaesthesiology and Intensive Care Medicine evaluates voluntary, standardized, everyday, perioperative anaesthesia outcome measures. A standard minimal data set is collected for national benchmarking. This article reviews the implementation of a data acquisition system in one academic centre that has participated in this long-term nationwide project since its initiation in 1992. The population studied comprised 96,107 patients up to 1997. The overall incidence of anaesthesia-related incidents, events and complications (IEC) was 22%. Results are presented and discussed for 63 different IEC, seven functional system categories and five severity grades. The proposed methodology, using computer-readable records, was suitable for comprehensive and detailed outcome documentation. However, an extensive data validation system was necessary. IEC reporting results were largely dependent on the documentation culture. The future of outcome tracking in routine anaesthesia may lie in multicentre comparisons with multivariate-adjusted risk and comorbidity data from each provider's integrated information system.