Abstract:
OBJECTIVE:This article outlines the formation of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) and describes its objectives, governance, functioning and challenges. BACKGROUND:A nationwide audit of surgical mortality provides an overview of the leading causes of death in patients who require surgical care. It identifies system or process errors, trends in deficiency of care and helps develop strategies to reduce deaths in the surgical arena. METHODS:A standardized tool is used to systematically collect data after every surgical death. Patient details are reviewed by a peer surgeon (and in certain cases a second) to identify issues with patient management and hospital processes. The treating surgeon is then offered confidential feedback and alternate views on patient management. RESULTS:From January 2009 to December 2012, 19,096 deaths were reported to the ANZASM. Eighty-six percent of the audited deaths occurred in patients requiring an emergency admission. Significant criticism of patient care was reported in 13% of cases with 16% of clinical issues perceived to be preventable. Western Australia, which first began the audit process, has shown a 30% reduction in surgical deaths. CONCLUSIONS:Nationwide mortality audits are a useful and worthwhile exercise. Recommendations identified in the audit reports direct educational workshops and seminars to address these issues. They allow Departments of Health to make informed decisions in their hospitals. Through this model, and the lessons learnt, we would encourage other countries planning to set up their own audits to follow a similar concept.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Raju RS,Guy GS,Majid AJ,Babidge W,Maddern GJdoi
10.1097/SLA.0000000000000581subject
Has Abstractpub_date
2015-02-01 00:00:00pages
304-8issue
2eissn
0003-4932issn
1528-1140journal_volume
261pub_type
杂志文章abstract::A prospective, randomized, blinded study was performed to determine whether prophylactic antibiotics would reduce the incidence of infection in peripheral vascular surgery and whether the route of antibiotic administration was important. Patients undergoing a vascular procedure with a groin incision were allocated to ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198009000-00011
更新日期:1980-09-01 00:00:00
abstract::In our series of 101 patients with small bowel bypass for morbid obesity, nine developed biliary calculi postoperatively during a mean follow-up of 29.6 months. The development of gallstones depends in part on biliary cholesterol saturation and on the zeta potential of bile. In eight consecutive patients, the lithogen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197801000-00011
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of health insurance expansion on racial disparities in severity of peripheral arterial disease. BACKGROUND:Lack of insurance and non-white race are associated with increased severity, increased amputation rates, and decreased revascularization rates in patients with peripheral artery d...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001310
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND:PJ and PG are established methods for reconstruction in pancreatoduod...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000001240
更新日期:2016-03-01 00:00:00
abstract::Previous reports suggest the value of renal decapsulation in the prevention of renal failure after acute ischemia. It has been suggested that this response is due to a release of "compartmental" pressure resulting in increased blood flow to the decapsulated kidney. Ten dogs were evaluated following 90 minutes of renal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198004000-00011
更新日期:1980-04-01 00:00:00
abstract:OBJECTIVE:This study was designed to examine the differential effects of tumor necrosis factor (TNF) and nitric oxide on the acute cardiovascular changes that occur in response to endotoxemia. SUMMARY BACKGROUND DATA:Recent studies have suggested that some, if not all, of the cardiovascular effects of TNF are mediated...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199601000-00009
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To examine preoperative dietary influences on gut-associated lymphoid tissue (GALT) cell number in the context of postoperative infectious complications. BACKGROUND:There is little clinical evidence regarding whether nutritional routes affect GALT size and/or phenotype. The influence of GALT atrophy on clini...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827a0e05
更新日期:2013-12-01 00:00:00
abstract::The effects of severe infection on luminal transport of amino acids and glucose by the small intestine were investigated. Studies were done in endotoxin-treated rats and in septic patients who underwent resection of otherwise normal small bowel. In rats the kinetics of the brush border glutamine transporter and the gl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199105000-00004
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:This study evaluates the effects of mechanical bowel preparation (MBP) on anastomosis below the peritoneal verge and questions the influence of MBP on anastomotic leakage in combination with a diverting ileostomy in lower colorectal surgery. SUMMARY BACKGROUND DATA:In a previous large multicenter randomized ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c0e75c
更新日期:2010-01-01 00:00:00
abstract::A prospective, manometric trial of anal fissure treated by subcutaneous lateral internal sphincterotomy (SLIS) was designed to elucidate the pathophysiology of this condition. Anorectal manometry with a closed, precalibrated, water-filled microballoon using the station pull-through technique was performed on 13 patien...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199002000-00017
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:The study was conducted to determine whether the performance of an extended lymphadenectomy and retroperitoneal soft-tissue clearance in association with a pancreatoduodenal resection improves the long-term survival of patients with a potentially curable adenocarcinoma of the head of the pancreas. SUMMARY BA...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-199810000-00007
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:Determine whether absorbable or nonabsorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared with suture repair. BACKGROUND:Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. P...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000842
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Advances in molecular biology have led to the identification of potential markers of prognostic and therapeutic importance in human cancers. HER-2 testing and targeted therapy now represents a critical cornerstone in the management of breast cancer. The objectives of the current study were to determine the...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181dbb77e
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To review the literature on chest wall resection for recurrent breast cancer and evaluate overall survival (OS) and quality-of-life (QOL) outcomes. BACKGROUND:Full-thickness chest wall resection for recurrent breast cancer is controversial, as historically these recurrences have been thought of as a harbinge...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000002310
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To explore the founding of the American Medical Association's Section on Surgery in 1859 and how it represented, on a national basis, the beginnings of organized surgery and the formal start of the professionalization and specialization of surgery in the United States. BACKGROUND:The broad social process of ...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/SLA.0000000000001635
更新日期:2017-01-01 00:00:00
abstract::Records of 32 patients with 34 villous and tubulovillous adenomas of the duodenum, treated at the Cleveland Clinic over the past 21 years, were reviewed. Twenty-two patients (69%) had complete resection of the adenoma; the incidence of malignancy was 47%. Five patients underwent a Whipple procedure; 4 patients had seg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198803000-00002
更新日期:1988-03-01 00:00:00
abstract::A new approach for preventing and treating sepsis due to central venous catheter (CVC) has been devised at the Istituto Nazionale Tumori of Milan. A prospective protocol has been developed that includes the weekly exchange of the CVC via a guidewire as well as its exchange when a CVC-related sepsis is suspected. Growt...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-198307000-00009
更新日期:1983-07-01 00:00:00
abstract::A randomized clinical trial was undertaken to compare early and delayed cholecystectomy for acute cholecystitis. Patients entering early (n = 83) or delayed (n = 82) surgery groups were comparable with regard to prerandomization data. One patient in the early group and five in the delayed group refused surgery (p < 0....
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198004000-00018
更新日期:1980-04-01 00:00:00
abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198512000-00004
更新日期:1985-12-01 00:00:00
abstract::Pressures in the Oddi sphincter and common bile duct were determined before, immediately after and several weeks after endoscopic papillotomy. Fifteen patients were included in the study. Significant decreases in Oddi sphincter and common bile duct pressures were found and the decrease in Oddi sphincter pressure was t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197908000-00009
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Pancreatic ductal adenocarcinoma (PDA) is a devastating disease that killed nearly 38,000 people in the United States this past year. OBJECTIVE:Treatment of PDA typically includes surgery and/or chemotherapy with gemcitabine. No reliable biomarker exists for prognosis or response to chemotherapy. Two previo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f1fd44
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of anesthesia induced mild systemic hypothermia on hepatic injury in lean and obese rats during warm ischemia. SUMMARY BACKGROUND DATA:Hepatic warm ischemia during surgery remains a significant problem, particularly in organs with presumed baseline dysfunction. METHODS:The left and me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000154259.73060.f1
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To compare the clinical presentation and results of treatment of postcholecystectomy bile duct injuries in patients with and without arterial injuries. SUMMARY BACKGROUND DATA:Incidence and impact of arterial injuries in patients with a postcholecystectomy biliary injury are unknown, although they are claime...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000074983.39297.c5
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the effects of radiofrequency ablation (RFA) on tumor growth and growth factor expression in a murine model. BACKGROUND:Surgical excision remains the only potentially curative therapy for hepatic malignancies. Tumor growth in the remaining liver may be accelerated aft...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000261319.51744.59
更新日期:2007-05-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:Previous studies have suggested a variety of factors that may affect the false negative (FN) rate for sentinel lymph node (SLN) biopsy in breast cancer. Because FN results are relatively rare, no prior studies have had sufficient sample size to allow detailed statistical analysis of factors pred...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.sla.0000165200.32722.02
更新日期:2005-06-01 00:00:00
abstract::Blunt carotid artery trauma is uncommon but has been associated with severe, permanent neurologic deficits in 42% and mortality in 30% of 96 patients previously reported in the English literature. Since neurologic symptoms characteristically develop only after a latent interval and since physical evidence of significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00014
更新日期:1980-03-01 00:00:00
abstract::Cadaver kidneys remain a scarce resource, yet single pediatric donor kidneys are underutilized at some centers. Between 1967 and 1984, 133 single pediatric and 318 adult donor cadaver transplants were performed. Patient and graft survival, renal function, and complications in adult recipients grouped by donor age were...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198608000-00011
更新日期:1986-08-01 00:00:00
abstract:AIM OF STUDY:The objective of this study was to determine the pattern of recurrence after one or more episodes of adhesive small bowel obstruction (ASBO) during a follow-up period of up to 40 years. Furthermore, we wanted to analyze possible factors with an influence on the recurrence rate and to study the magnitude of...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000132988.50122.de
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:The Hepp-Couinaud technique describes side-to-side HJ to the main left hepatic duct but a side-to-side approach is not consistently used when repairing other ducts. Compared with end-to-side repairs, side-to-side anastomoses require less dissection, theoretically preserving blood supply to the bile ducts, an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6b2e
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the accuracy of abdominal ultrasonography (US) for screening and grading pediatric splenic injury. SUMMARY BACKGROUND DATA:The use of abdominal US has increased rapidly as a method of evaluating organ damage after blunt abdominal trauma. Despite US's increasing use, ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199704000-00010
更新日期:1997-04-01 00:00:00