General survey of the causes of death in patients who died postoperatively in pediatric surgery.

The study is based on 427 patients who died between 1949 and 1976 and who were subjected to a post mortem examination. The years 1949 to 1969 (Group A) and the years 1970 to 1976 (Group B) were compared. Following important results were discovered: The underlying disease as a cause of postoperative death was reduced from 18.5% in Group A to 13.3% in Group B. Postoperative deaths secondary to associated malformations increased from 2.5% to 6.1%. Postoperative deaths due to a wrong diagnosis remained constant at 3%. Deaths due to wrong medical treatment decreased from 18% to 5.1%. Deaths due to postoperative infection increased from 17% to 46.2%. The explanation for this change is that modern intensive care keeps many patients alive who formerly died before the onset of infection. Deaths secondary to postoperative shock remained practically constant at 3% and 4% respectively. Deaths due to postoperative pneumonia decreased from 31% in Group A to 13.3% in Group B. The therapy for pneumonia has therefore markedly improved. The largest number of postoperative deaths was found in newborn infants. However, their part in the total numbers of postoperative deaths is definitely becoming smaller. Amongst the newborn infants there was the highest number of postoperative deaths caused by infections.