Wednesday, October 31, 2007
13425

Mortality In Outpatient Surgery - AAAASF Report

Geoffrey R. Keyes, MD

The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) has reported statistics on morbidity and mortality for facilities that it accredits based upon an analysis of unanticipated sequelae and surgical mortality. Data acquired through the implementation of the first Internet Based Quality Assurance and Peer Review reporting system (IBQAP) was reviewed and published in 2004. 1378 significant unanticipated sequelae and 8 postoperative deaths were documented in 411,617 procedures performed over a two-year period from 2001 through 2002.

In a current review of data collected using IBQAP from years 2001 through 2006, there were 22 deaths in 1,141,418 outpatient procedures performed. Pulmonary embolism was the etiology in twelve of the twenty-two deaths. Only one death occurred as the result of an intraoperative adverse event.

A pulmonary embolism may occur following any operative procedure, whether the procedure is performed in a hospital, an ambulatory surgery center, or a physician's office based surgery facility.

The procedure most commonly associated with mortality through pulmonary embolism in an office based surgery facility is an abdominoplasty. The frequency of pulmonary embolism associated with abdominoplasty warrants further study to elucidate the mechanism of its etiology, determine predisposing factors, and to introduce guidelines to prevent its occurrence.