Perioperative mortality in Zambia.

An audit of 10,592 consecutive operations performed during 7 months in a central African teaching hospital is presented. Eighty deaths occurred within 6 days of operation, an overall mortality rate (OMR) of 7.55 per 1000 operations. Deaths are classified as avoidable or unavoidable. Avoidable deaths are those for which there was evidence of mismanagement of a type and degree sufficient to account for the death. There were 35 avoidable deaths, an avoidable mortality rate (AMR) of 3.3 per 1000 operations. Avoidable factors which contributed to death are classified as surgical, anaesthetic, and administrative. Surgery and anaesthesia at this hospital are described, and possible means of decreasing avoidable mortality discussed. The value of combined anaesthetic and surgical audit is emphasised.