Recording and classification of complications in a surgical practice

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. Copyright © 1999 Taylor and Francis Ltd.