Latest statistics show that anaesthesia still remains very safe

04 August, 2009

Anaesthesia in Australia and New Zealand remains extremely safe, according to the latest statistics released recently.

According to the report “Safety of Anaesthesia: a review of anaesthesia-related
mortality in Australia and New Zealand 2003-2005” published by the Australian and
New Zealand College of Anaesthetists (ANZCA), there was a decrease in all
categories of anaesthesia-related mortality compared to the previous triennium.

There was also a decrease in the number of cases in which a correctable factor could be identified.

This major safety report is compiled by ANZCA every three years, using data
provided from State and Territory Anaesthesia Mortality Committees.

Mortality reporting is a long recognised method of monitoring the quality of health
care. This is the seventh triennial anaesthesia mortality report published in Australia,
the first being for the 1985-1987 triennium.

All these reports have demonstrated very low anaesthesia-related mortality, both in
absolute terms, and in comparison to other developed countries.

For the 2003-2005 triennium, data was received only from New South Wales,
Victoria and Western Australia which together make up two thirds of Australia’s
population. Unfortunately, unlike previous reports, no data was received from South
Australia, the Northern Territory, Tasmania or Queensland.

The Australian Capital Territory and New Zealand have not contributed data to
reports so far, but it is hoped that they will be in a position to contribute data in
future reports.

While Tasmania did not contribute to this report, its mortality committee is now functioning well and will be in a position to contribute data in the next report.

New Zealand has indicated it is willing to reestablish mortality reporting
and South Australia has also indicated that it will participate in future reports with
assistance from ANZCA to establish its mortality committee.

The number of anaesthesia-related deaths reported from the three states which
supplied data was 112. Of these, 24 cases were classified as category 1 (where it was considered “reasonably certain” that death was caused by anaesthesia factors
alone). In 33 cases there was “some doubt” (category 2), and the remaining 55 cases, “both anaesthetic and surgical” factors were implicated (category 3).

The overall anaesthesia-related mortality rate for these three states was 1 for every
53, 426 anaesthetics.

In terms of population, there were about 2.73 deaths per million population per
annum. If anaesthesia as a “sole cause” for death is considered, the rate is about one
death in every 250,000 anaesthetics.

The majority of anaesthesia-related deaths (75%) occurred in older patients (age 60+
years). A small proportion (16%) continues to occur in patients considered low risk.
As in previous years, orthopaedic and abdominal surgical procedures were the most
common. The majority of deaths occurred in an intensive care unit, high
dependency unit, or operating theatre.

Releasing the report, the President of ANZCA and Chair of the ANZCA Mortality
Working Group, Dr Leona Wilson said that the long established practice of collection
and analysis of anaesthesia-related mortality data has helped ensure the high quality
and safety of anaesthesia in Australia and New Zealand.

“Australian and New Zealand anaesthetists are leaders in their field; their
commitment is shown by the high rate of reporting despite this being in most cases
voluntary. This report provides a rich source of information for anaesthetists,
anaesthesia trainees and their supervisors”.

Dr Wilson, however, said that the absence of data from New Zealand, Queensland,
South Australia, Tasmania and the Northern Territory was of “major concern”.

“While Tasmania has commenced mortality reporting and there has been progress
towards the establishment of anaesthesia mortality reporting in the Australian
Capital Territory and re-establishment in South Australia and New Zealand, there is
no anticipated re-institution of the Queensland Mortality Committee.

“ANZCA believes that a return to full function of the anaesthetic mortality
committees in New Zealand, Queensland and South Australia should be encouraged
as a matter of urgency. It is pleasing that South Australia has recently indicated its
willingness to provide funding for an anaesthetic mortality committee”.

The report found that even though anaesthesia-related death “is exceptionally rare,
it is clear that the risk remains ever present, even in low risk patients. Therefore,
anaesthesia-related care should be provided or supervised by specialist
anaesthetists wherever possible”.

Dr Wilson said there was a continuing need for research and continuing education to
improve Australia and New Zealand’s record of patient safety to eliminate
anaesthesia-related deaths.