Use of the Morbidity and Mortality Conference to Analyze Patient Death in Plastic Surgery: A 13-Year, Single Institution Experience

Purpose: Morbidity and mortality (M&M) conferences have been an integral part of medical and surgical education for nearly a century. Despite this fact, the systematic reporting of mortality data is lacking in many surgical fields including plastic and reconstructive surgery. Current plastic surgery literature is mainly limited to adverse events associated with specific procedures.

 

Methods: We evaluated 13 years of data collected at our monthly M&M conference.  Paper records were entered into a HIPAA compliant digital database capable of prospectively maintaining future data.  Data was reviewed for five surgical services in four different hospitals that comprise the vast majority of our department’s activity.

 

Results: Between 2000 and 2013, our plastic surgery department performed a total of 60,834 cases. In this time, a total of 829 M&M case reports were submitted (1.4%). Of the submitted M&M case reports, a total of 25 cases (0.04%) had an end outcome of death (24) or brain death (1).  Deaths were either directly or indirectly associated with cardiopulmonary causes, multisystem organ failure, sepsis, massive bleeding, CVA, saddle embolism, or unknown causes.

 

Conclusions: To our knowledge, this study uses the largest sample of cases performed by a single academic plastic surgery service to report overall mortality data.