Original scientific articleIdentification of Surgical Complications and Deaths: An Assessment of the Traditional Surgical Morbidity and Mortality Conference Compared with the American College of Surgeons-National Surgical Quality Improvement Program
Section snippets
Methods
Morbidity and mortality rates were tabulated from the traditional weekly M&M conference from the General Surgical Services at the Massachusetts General Hospital for the academic year July 1, 2002, to June 30, 2003, and compared with M&M as determined by the NSQIP nurse-reviewer during the identical time period. Occurrence rates were calculated as the number of total occurrences divided by the number of major general surgical cases. Univariate analyses of the data were performed using chi-square
Results
Of the 7,916 procedures performed by the General Surgical Services at our hospital in the academic year of 2002 to 2003, 5,905 met NSQIP inclusion criteria. Our NSQIP nurse-reviewer captured 1,439 of these procedures, a 24% sample.
Mortality rate, as calculated by the traditional M&M conference compared with the NSQIP nurse-reviewer, was 0.9% versus 1.9% (p = 0.001)(Table 1). By extrapolation from the 24% sample size, this means that 1 of every 2 deaths was not presented at the M&M conference,
Discussion
We found that the traditional M&M conference at our institution substantially underreported both in-hospital and postdischarge complications and deaths as compared with data collected using ACS-NSQIP techniques. Approximately one of two deaths and three of four complications were not presented in the M&M conference at our institution.
Sparse information about the accuracy of M&M conferences exists in the medical literature, so it is difficult to know if these findings are an isolated event at
Acknowledgment
We would like to thank Sherwood Hughes and Steve Merzlak, and Henry Chueh, Mike Franklin, and Kathryn Lau from the MGH Laboratory of Computer Science for their efforts in creating our intranet-based reporting tool for M&M conference.
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Competing Interests Declared: None.