[Perioperative mortality and the role of anesthesiologic activity at the Vrije University Hospital in Amsterdam]. / Perioperatieve sterfte en het aandeel van het anesthesiologisch handelen binnen het Academisch Ziekenhuis Vrije Universiteit te Amsterdam.

OBJECTIVE: To determine the perioperative mortality and the share of anaesthesiological activity in it. DESIGN: Retrospective, descriptive. SETTING: VU University Hospital, Amsterdam. METHOD: Patients who in the period 1989-1994 had died within 7 days after a clinical surgical intervention were identified using the database of the hospital information system. The following data concerning these patients were collected from the database of the department of Anaesthesiology: age, sex, classification according to the American Society of Anesthesiologists (ASA), urgency (elective or emergency operation), type of operation (12 categories), duration of the operation, time and place of death. Four independent investigators classified the deceased patients with the aid of their medical files as to the degree of connection between the anaesthesiological activity and the death according to the Edwards classification. RESULTS: A total of 62,969 operations had been performed. following which 314 patients (0.5%) had died within 7 days. Death was connected with the anaesthesiological activity in 16 cases (2.5 per 10,000 operations): there was a connection with the anaesthesiological activity exclusively in two patients (0.3 per 10,000 operations) and with both anaesthesiological and surgical factors in 14 patients (2.2 per 10,000 operations). Advanced age, male sex, a higher ASA category, traumatological operations and emergency operations were associated with a higher mortality rate. CONCLUSION: The mortality rate within 7 days after a clinical surgical intervention was 0.5%. A connection with anaesthesiological activity was present in 2.5 per 10,000 operations.