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Recording and classification of complications in a surgical practice
M R Veen1, J W Lardenoye, G W Kastelein
1Department of Surgery, Rode Kruis Ziekenhuis, The Hague, The Netherlands.
Objective:
To document the incidence and outcome of complications in the department of surgery.
Design:
Retrospective study.
Setting:
District hospital, The Netherlands.
Subjects:
7455 patients operated on between 1 January 1993 and 31 December 1995.
Main Outcome Measures:
Documentation and outcome of complications (defined as "every unwanted development in the illness of the patient or in the treatment of the patient's illness that occurs in the clinic").
Results:
1078 complications were recorded after 8130 operations (13%), 337 (33%) of which had no long term effects. 175/1078 (16%) required reoperation, and in 134 of these (77%) an error in management or surgical technique was responsible for the complication. 6 patients were irreversibly harmed and of the 141 patients who died, 11 had evidence of some sort of error.
Conclusions:
Audit of complications is necessary to improve practice in a surgical department, and weekly morbidity and mortality meetings are a good opportunity for learning about them.