The value of a mortality-scoring system in the quality control of patientsundergoing abdominal aortic surgery

Objectives: to assess the quality of care of patients undergoing abdominal aortic surgery. Materials: three hundred and forty-six patients undergoing surgery for aneurysmal or occlusive disease of whom 51 died. Methods: we developed a mortality registration system to classify causes of death, to evaluate shortcomings in treatment, and to determine the extent of agreement between clinical diagnosis and necropsy findings. Results: the main cause of death for 11 patients (22%) was a poor clinical condition at admission, while 76% (n=39) of the patients died due to postop erative complications. Myocardial infarction was the most frequently encoun tered complication. Deficiencies in medical treatment were observed in 10 o f the 51 deaths (20%). Autopsy was performed in 33 of the 51 patients (65%) , revealing in 10 cases (30%) a major discrepancy between pre- and postmort em findings. Six of the 10 autopsies revealed that a myocardial infarction had been missed during the postoperative period. Conclusions: autopsy reports are essential for accurately estimating compli cations rates as we observed discrepancies in 30% of cases.