Adverse operative events in neurosurgical training: incidence, trends and proposals for prevention

We prospectively studied the adverse operative events encountered during the first 4.5 years of a single neurosurgeon's career (JP). We investigated the incidence of these events and their distribution over time, and recorded risk factors in causation. Twenty-three adverse events were identified in 728 cases studied. These all occurred in one of four categories of operation: craniotomy, shunt placement, spinal surgery and stereotactic biopsy. The incidence of adverse operative events varied between 5.8% for spinal operations to 9.5% for stereotactic biopsy. There was evidence of a reducing incidence of adverse operative events over time in some operative groups. The two categories with the highest incidence of adverse operative events were the same two categories with the lowest number of assisted cases per 100 operations performed.