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Australia's national surgical mortality audit shows a significant, progressive fall in surgical death rates nationwide. This audit provides extensive educational feedback to surgeons and hospitals, contributing to improved patient safety.

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Area of Science:

  • Healthcare Quality and Safety
  • Surgical Outcomes Research
  • Public Health Surveillance

Background:

  • Australia uniquely operates a national surgical mortality audit system.
  • All surgical deaths undergo independent external review by a peer surgeon.
  • Extensive educational feedback is disseminated to surgeons and hospitals.

Purpose of the Study:

  • To conduct a longitudinal analysis of Australia's national surgical mortality audit.
  • To assess trends in surgical mortality rates across states, territories, and specialties.

Main Methods:

  • Standardised Mortality Ratios (SMRs) were calculated for states, territories, and nine surgical specialties.
  • Data were analyzed nationally and grouped into all deaths, postoperative deaths, and non-operative deaths.
  • Longitudinal analysis compared current data to an index year (2016 or earlier for some states).

Main Results:

  • A consistent, progressive fall in SMRs, exceeding 20%, was observed across all states, territories, and specialties compared to the index year.
  • This national decline in surgical mortality was statistically significant (p=0.044).
  • States with longer-term data showed similar trends in earlier periods.

Conclusions:

  • The observational period coincided with a nationwide reduction in surgical mortality.
  • While improvements in care likely contributed, the specific impact of the national audit on reduced surgical mortality remains uncertain.