[Content of a weekly morbidity and mortality conference in visceral surgery]

Abstract

Background: 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.

Objective: Detailed analysis of the content of a weekly M&M conference in a department of general and visceral surgery.

Material and methods: Data from a weekly 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.

Results: From 1 January 2010 to 31 December 2014 a total of 761 out of 11,470 patients with a mean 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 a medical complication and 91 patients (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-Dindo I (30.0%) and Clavien-Dindo III (40.9%), medical complications were most often classified as Clavien-Dindo IV (29.6%) and V (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.

Conclusion: The M&M conferences display a morbidity profile of each surgical department. Depending on the speciality and focus of a surgical 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.

Keywords: Complications; Medical complications; Morbidity and mortality conference; Quality control; Surgical complications.