Taylor Jessica, Dixon Liane, Pascoe Rebecca, Dobbs Bruce, Kennedy Ross, Frizelle Frank
Anaesthetic Registrar, Department of Anaesthesia, Dunedin Hospital, Dunedin.
Clinical Studies Research Nurse, Department of Surgery, Christchurch Hospital, Christchurch.
N Z Med J. 2016 Dec 16;129(1447):64-71.
Most studies assessing mortality after surgery have been undertaken in major public hospitals or are procedure specific. The aim of this study was to determine mortality after elective surgery at a total community level with inclusion of all patients undergoing elective surgery.
This was a prospective study of all patients that underwent elective surgery in Christchurch, New Zealand, within a calendar month. For each patient, we collected demographic data, American Society of Anaesthesiologists physical status classification (ASA), type of anaesthetic and surgical specialty. The primary outcome was 30-day mortality and the secondary outcome was 90-day mortality.
Four thousand seven hundred and fifteen patients were included in this study. Two thousand five hundred and seventy-eight (55%) were female and the median age was 56 years (range 0-99 years). Three thousand one hundred and forty-two (67%) patients had a general anaesthetic. By day 30, 11 (0.2%) patients had died and by day 90, 27 (0.6%) patients had died. Of the 27 deaths within 90 days after surgery, one was possibly anaesthesia-related (0.02%), while the majority were due to progression of disease (18).
This study shows a lower mortality than what has previously been reported for elective surgical procedures when the denominator is the total community number of operations.
大多数评估手术后死亡率的研究是在大型公立医院进行的，或是针对特定手术的。本研究的目的是确定在整个社区层面择期手术后的死亡率，纳入所有接受择期手术的患者。
这是一项对在新西兰克赖斯特彻奇一个日历月内接受择期手术的所有患者的前瞻性研究。对于每位患者，我们收集了人口统计学数据、美国麻醉医师协会身体状况分类（ASA）、麻醉类型和手术专科。主要结局是30天死亡率，次要结局是90天死亡率。
本研究纳入了4715名患者。2578名（55%）为女性，中位年龄为56岁（范围0 - 99岁）。3142名（67%）患者接受了全身麻醉。到第30天，11名（0.2%）患者死亡，到第90天，27名（0.6%）患者死亡。在术后90天内的27例死亡中，1例可能与麻醉相关（0.02%），而大多数是由于疾病进展（18例）。
本研究表明，以社区手术总数为分母时，择期手术的死亡率低于先前报道的水平。
