27 November 2015
The 6 th National Report of the Australian and New Zealand
Audits of Surgical Mortality (ANZASM) was released today by the
Royal Australasian College of Surgeons (RACS), highlighting a
significant drop in the number of adverse events due to issues with
The Report, involving the clinical review of all cases where
patients have died while under the care of a surgeons, pointed
strongly to safer surgical health care practices as surgeons become
more engaged in the audit process.
The Chair of ANZASM, Professor Guy Maddern said that the
reduction in adverse events was a promising finding, and he was
pleased by the way the audit had evolved since it was introduced in
"The 4 per cent figure observed for adverse events in 2014 is
the lowest figure observed yet and follows an overall decrease over
"Whether this is as a direct result of more surgeons
participating in the audit process is impossible to say, but going
by the figures alone, the reduction in adverse events has occurred
simultaneously with greater engagement in the audit process from
"When this process first began we had 60 per cent of surgeons
participating; in 2014 this figure has risen to 97 per cent," Prof
The mortality audit programme is part of a quality assurance
activity aimed at the ongoing improvement of surgical care.
Clinical reviews are conducted by surgeons who practice in the same
specialty but from a different hospital.
For the first time in 2014 the Report included a specific
section on Aboriginal and Torres Strait Islander people, which
highlighted some significant health issues between Indigenous and
"We found that there was no difference in the level of surgical
care received by Aboriginal and Torres Strait Islander people,
however, there were noticeable differences in the age and general
health of this group when compared to the overall population"
Professor Maddern said.
"Aboriginal and Torrens Strait Islander people were on average
younger, and had a much higher rate of serious comorbidities that
surgeons felt contributed to death."
Professor Maddern said other key highlights from the 2014 report
- In the
majority of instances those patients expected to benefit from
critical care support received it. The review process suggested
that only 1% of patients who did not receive treatment in a
critical care unit would most likely have benefited from
- Fluid balance
in the surgical patient is an ongoing challenge; however the report
highlights improvements are being made in this area. 6% of patients
were perceived to have had poor fluid management, down from 10% of
patients in 2012.
- The audit
revealed that surgical emergencies are greater risks for patients
where care is shared. For example, patients were much more likely
to be at risk when inter-hospital transfers were
- The audit now
includes Fellows from the Royal Australian and New Zealand College
of Obstetricians and Gynaecologists. It is encouraging to note a
participation rate of over 55% by gynaecological Fellows, and we
anticipate these numbers will grow over time in much the same
manner they have with RACS Fellows.
Managed and funded by RACS and the state and territory
departments of Health, ANZASM presents the outcome of clinical
reviews conducted into 23,292 deaths that completed the full audit
process from 1 January 2009 to 31 December 2014.
The 2014 ANZASM Report is available on the RACS
Download full media release (PDF 195KB)