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134912 - Systemic predictors of adverse events in a national surgical mortality audit - Final author version.pdf (208.72 kB)

Systemic predictors of adverse events in a national surgical mortality audit: analysis of peer-review data from Australia and New Zealand Audit of Surgical Mortality

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posted on 2023-05-20, 07:06 authored by Richard TurnerRichard Turner, Steve Simpson JRSteve Simpson JR, Mrunmayee BhaleraoMrunmayee Bhalerao
Background: Peer review of surgical deaths can identify deficits in individual and systemic delivery of healthcare, ultimately informing quality improvement.

Methods: From 2008 to 2016, cases reported to the Australia and New Zealand Audit of Surgical Mortality were analysed. Variables associated with peer-judged adverse events were sought.

Results: Of 21 045 cases evaluated, 24.8% incurred at least one adverse event judgement. The proportion of cases with reported adverse event significantly decreased over time. Following adjustment for demographic and clinical characteristics, significant negative patient-related associations were advanced age, greater American Society of Anesthesiologists grade, and neurological and malignant comorbidities. Significant associations were also found with systemic or organizational factors, including state/territory, surgical specialty and hospital regionality.

Conclusion: Examination of this peer-reviewed database revealed systemic or organizational predictors of adverse events that may have implications for quality improvement at an institutional or jurisdictional level. The extent to which these associations are due to the peer-review process itself should be the focus of further research.

History

Publication title

ANZ Journal of Surgery

Volume

89

Issue

11

Pagination

1398-1403

ISSN

1445-1433

Department/School

Tasmanian School of Medicine

Publisher

Blackwell Publishing Asia

Place of publication

54 University St, P O Box 378, Carlton, Australia, Victoria, 3053

Rights statement

© 2019 Royal Australasian College of Surgeons

Repository Status

  • Restricted

Socio-economic Objectives

Treatment of human diseases and conditions; Evaluation of health outcomes; Public health (excl. specific population health) not elsewhere classified

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