BACKGROUND: Postoperative death following large bowel surgery is relatively infrequent and no large study has analysed the cause of all deaths comprehensively and critically. METHODS: In-hospital deaths following large bowel surgery in South-East Scotland were reviewed by independent assessors. The audit was confidential but not anonymous. Independent assessors' reports were returned to consultants. RESULTS: The audit documented 187 deaths. The independent assessors noted an adverse event in 78 patients (42 per cent). Twenty-six deaths (14 per cent) occurred following an anastomotic leak. A further 43 deaths (23 per cent) occurred because surgery was delayed (17) or there was undue delay in making the initial diagnosis (12) or recognizing a developing complication (14). Consultants operated on only half the patients classed as American Society of Anesthesiologists grade IV or V, or undergoing a second or subsequent operation. CONCLUSION: Half the patients dying in this study had identifiable deficiencies in their management. There is a clear need for greater consultant input with critically ill patients.
BACKGROUND:Postoperative death following large bowel surgery is relatively infrequent and no large study has analysed the cause of all deaths comprehensively and critically. METHODS: In-hospital deaths following large bowel surgery in South-East Scotland were reviewed by independent assessors. The audit was confidential but not anonymous. Independent assessors' reports were returned to consultants. RESULTS: The audit documented 187 deaths. The independent assessors noted an adverse event in 78 patients (42 per cent). Twenty-six deaths (14 per cent) occurred following an anastomotic leak. A further 43 deaths (23 per cent) occurred because surgery was delayed (17) or there was undue delay in making the initial diagnosis (12) or recognizing a developing complication (14). Consultants operated on only half the patients classed as American Society of Anesthesiologists grade IV or V, or undergoing a second or subsequent operation. CONCLUSION: Half the patients dying in this study had identifiable deficiencies in their management. There is a clear need for greater consultant input with critically illpatients.
Authors: J G Williams; S E Roberts; M F Ali; W Y Cheung; D R Cohen; G Demery; A Edwards; M Greer; M D Hellier; H A Hutchings; B Ip; M F Longo; I T Russell; H A Snooks; J C Williams Journal: Gut Date: 2007-02 Impact factor: 23.059
Authors: Niels Komen; Juliette Slieker; Paul Willemsen; Guido Mannaerts; Piet Pattyn; Tom Karsten; Hans de Wilt; Erwin van der Harst; Willem van Leeuwen; Christine Decaestecker; Hans Jeekel; Johan F Lange Journal: Int J Colorectal Dis Date: 2014-01 Impact factor: 2.571
Authors: M S Scepanovic; B Kovacevic; V Cijan; A Antic; Z Petrovic; R Asceric; I Krdzic; V Cuk Journal: Tech Coloproctol Date: 2013-04-26 Impact factor: 3.781