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Br J Anaesth. 1978 Oct;50(10):1041-6.

Death attributable to anaesthesia. A 10-year survey (1967--1976).


The mortality associated with 240 483 anaesthetics administered over 10 years at Groote Schuur Hospital, Cape Town, is reported. The frequency of death to which anaesthesia contributed was 0.22 per 1000 anaesthetics (compared with 0.33 per 1000 in the previous 10 years). These deaths were responsible for 2.2% of the total mortality from surgery. Two-thirds of the "anaesthetic" deaths were attributable to (in order of frequency): (a) hypovolaemia; (b) respiratory inadequacy following myoneural blockade; (c) complications of tracheal intubation; (d) inadequate postoperative care and supervision.


Data from the years 1967-1976 which assessed the mortality associated with anesthesia at Groote Schuur Hospital, Cape Town, South Africa, are reported. Mortality associated with use of 240,483 anesthetics showed frequency of death, to which anesthetic was a contributor factor, to be .22/1000 anesthetics. This figure compares well with the figures reported for the previous 10 years (.33/1000 anesthetics). Anesthetic-related deaths accounted for 2.2% of surgery deaths in the decade studied. 4 main etiological causes were apparent, covering two-thirds of anesthetic deaths; these were, in order of declining frequency: 1) hypovolemia; 2) respiratory inadequacy after myoneural blockade; 3) complications of tracheal intubation; and 4) inadequate postoperative care and supervision. The following changes are recommended to improve anesthetic delivery and safety: 1) continuing improvement in routine monitoring of vital functions during anesthesia; 2) increase in the consultant (full time specialist)-registrar (trainee) ratio, which at this report was approximately 1:1; 3) decrease in the case load per anesthestitist; and 4) introduction of recovery rooms within the surgery theater area and adjacent intensive care units.

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