Content of aweekly morbidity and mortality conference in visceral surgery

Abstract

Morbidity and mortality (M&M) conferences are essential instruments for quality improvement in surgical departments; however, publications concerning the detailed contents of M&M conferences are rare and have not been published in the German language. Detailed analysis of the content of aweekly M&M conference in adepartment of general and visceral surgery. Data from aweekly M&M conference were prospectively collected. Epidemiological data, diagnosis, type of surgery, morbidity, postoperative course and mortality were documented for each patient. Type (surgical vs. medicinal) and severity (I-V according to Clavien-Dindo classification) of complications were analyzed. From 1 January 2010 to 31 December 2014 a total of 761 out of 11,470 patients with amean age of 62.2 (15.9) years were discussed in the M&M conferences. Of the M&M patients 39.4% were female, 88.9% showed surgical complications while 28.9% were diagnosed with amedical complication and 91patients (12.0%) died. Complications were classified as Clavien-Dindo I:27.9%, II:10.5%, III:37.7%, IV:12% and V:12.0%. Most surgical complications were classified as Clavien-DindoI (30.0%) and Clavien-DindoIII (40.9%), medical complications were most often classified as Clavien-DindoIV (29.6%) andV (34.6%). Wound healing impairment (41%), pulmonary complications (16.6%), anastomotic leakage (15.6%), septic (8.9%) and cardiac (8.0%) complications were discussed most often. Cardiac, pulmonary and septic complications were the main cause of morbidity in deceased patients. The M&M conferences display amorbidity profile of each surgical department. Depending on the speciality and focus of asurgical department, the content of the M&M conferences will vary. Detailed knowledge about the content of M&M conferences enable specific measures to be taken to improve quality and patient safety.