Operating room deaths—An analysis of mortality in central hospital Benin City over ten years.

Abstract

Background: Death on the operating table is a traumatic, depressing, and dreaded experience for the Surgeon and the Anaesthetist, resulting in self-guilt and re-evaluation of perioperative events.

Methods: The operating room records, anaesthetic charts, and patient case notes for all Urological and General surgery patients who died intraoperatively were identified. The records were scrutinised for the type of surgery, operating findings, and possible cause of death. The duration of illness before presentation and the time taken to prepare the patient for the surgical procedure were also noted. The risk grading of the physical status of the patients as assigned by the attending anaesthetist was recorded.

Results: Twenty-four intraoperative deaths occurred accounting for 0.89% with a male preponderance (1.7:1). Gastrointestinal diseases and abdominal trauma injury are the major cause of intraoperative room deaths. Patients with chronic illnesses are most likely to die due to delay in presentation. The majority of cases were done as emergency cases and mainly ASA V moribund patients who are not expected to survive without the surgical operation. General anaesthesia was mostly utilised during perioperative death and more than half of the secondary cause of death was due to haemorrhage.

Conclusion: This study shows operating room deaths are rare but occur more commonly in secondary facilities than tertiary centres. Patients with poor physical status and receiving abdominal procedures are more likely to suffer perioperative deaths. Early presentation and adequate preoperative optimization of the patients may result in good outcomes.