Most<unk>  is attributable to complications from the operation (such as bleeding, sepsis, and failure of vital organs) or pre-existing medical conditions.. Although in some high-resource health care systems, statistics are kept by mandatory reporting of<unk> , this is not done in most countries. For this reason a figure for total global<unk>  can only be estimated. A study based on extrapolation from existing data sources estimated that 4.2 million people die within 30 days of surgery every year, with half of these deaths occurring in low- and middle-income countries.<unk>  figures can be published in league tables that compare the quality of hospitals. Critics of this system point out that<unk>  may not reflect poor performance but could be caused by other factors, e.g. a high proportion of acute/unplanned surgery, or other patient-related factors. Most hospitals have regular meetings to discuss surgical complications and<unk> . Specific cases may be investigated more closely if a preventable cause has been identified. Globally, there are few studies comparing<unk>  across different health systems. One prospective study of 10,745 adult patients undergoing emergency abdominal surgery from 357 centres across 58 countries found that mortality is three times higher in low- compared with high-human development index (HDI) countries even when adjusted for prognostic factors. In this study the overall global mortality rate was 1·6 per cent at 24 hours (high HDI 1·1 per cent, middle HDI 1·9 per cent, low HDI 3·4 per cent), increasing to 5·4 per cent by 30 days (high HDI 4·5 per cent, middle HDI 6·0 per cent, low HDI 8·6 per cent; P < 0·001). A sub-study of 1,409 children undergoing emergency abdominal surgery from 253 centres across 43 countries found that adjusted mortality in children following surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. This translate to 40 excess deaths per 1000 procedures performed in these settings. Patient safety factors were suggested to play an important role, with use of the WHO Surgical Safety Checklist associated with reduced mortality at 30 days. Mortality directly related to anesthetic management is less common, and may include such causes as pulmonary aspiration of gastric contents, asphyxiation and anaphylaxis. These in turn may result from malfunction of anesthesia-related equipment or more commonly, human error. A 1978 study found that 82% of preventable anesthesia mishaps were the result of human error. In a 1954 review of 599,548 surgical procedures at 10 hospitals in the United States between 19481952, 384 deaths were attributed to anesthesia, for an overall mortality rate of 0.064%. In 1984, after a television program highlighting anesthesia mishaps aired in the United States, American anesthesiologist Ellison C. Pierce appointed a committee called the Anesthesia Patient Safety and Risk Management Committee of the American Society of Anesthesiologists. This committee was tasked with determining and reducing the causes of peri-anesthetic morbidity and mortality. An outgrowth of this committee, the Anesthesia Patient Safety Foundation was created in 1985 as an independent, nonprofit corporation with the vision that "no patient shall be harmed by anesthesia". The current mortality attributable to the management of general anesthesia is controversial. Most current estimates of<unk>  range from 1 death in 53 anesthetics to 1 in 5,417 anesthetics. The incidence of<unk>  that is directly attributable to anesthesia ranges from 1 in 6,795 to 1 in 200,200 anesthetics. There are some studies however that report a much lower mortality rate. For example, a 1997 Canadian retrospective review of 2,830,000 oral surgical procedures in Ontario between 19731995 reported only four deaths in cases in which either an oral and maxillofacial surgeon or a dentist with specialized training in anesthesia administered the general anesthetic or deep sedation. The authors calculated an overall mortality rate of 1.4 per 1,000,000. It is suggested that these wide ranges may be caused by differences in operational definitions and reporting sources. The largest study of postoperative mortality was published in 2010. In this review of 3.7 million surgical procedures at 102 hospitals in the Netherlands during 19912005, postoperative mortality from all causes was observed in 67,879 patients, for an overall rate of 1.85%. Anaesthesiologists are committed to continuously reducing<unk>  and morbidity. In 2010, the principal European anaesthesiology organisations launched The Helsinki Declaration for Patient Safety in Anaesthesiology, a practically-based manifesto for improving anaesthesia care in Europe.
Perioperative mortality
Case fatality rate
Mortality rate
Risk of mortality
Infection rate
Cancer slope factor
Survival rate
Disease burden