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John D Birkmeyer - One of the best experts on this subject based on the ideXlab platform.
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ranking hospitals on Surgical Mortality the importance of reliability adjustment
Health Services Research, 2010Co-Authors: Justin B Dimick, Douglas O. Staiger, John D BirkmeyerAbstract:Objective We examined the implications of reliability adjustment on hospital Mortality with surgery.
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understanding and reducing variation in Surgical Mortality
Annual Review of Medicine, 2009Co-Authors: John D Birkmeyer, Justin B DimickAbstract:Surgical Mortality varies widely across hospitals and surgeons, more so than would be predicted by chance alone or differences in case mix. Although a large body of research has suggested the importance of procedure volume, clinical mechanisms underlying variation in Surgical Mortality remain largely unknown. Payers, policy makers, and professional organizations have implemented a variety of large-scale strategies aimed at improving outcomes. Selective referral, process compliance, and outcomes measurement reflect different philosophies on how best to improve Surgical quality and have distinct advantages and disadvantages. The optimal strategy may depend on both the clinical context (e.g., which procedure) and political realities.
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Composite Measures For Predicting Surgical Mortality In The Hospital
Health affairs (Project Hope), 2009Co-Authors: Justin B Dimick, Onur Baser, Douglas O. Staiger, John D BirkmeyerAbstract:Although payers increasingly report information on hospital volume and Mortality from surgery, the value of these data is uncertain. Using national Medicare data for six Surgical operations (covering the years 2003–2006), we created a composite measure based on these two quality indicators. We found that this simple measure was a strong predictor of future performance for all six operations. In this regard, it was more effective than the individual measures. Such measures would be useful for helping patients and payers identify low-Mortality hospitals for major surgery.
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Socioeconomic Status and Surgical Mortality in the Elderly
Medical care, 2008Co-Authors: Nancy J. O. Birkmeyer, Onur Baser, Arden M. Morris, John D BirkmeyerAbstract:Background:Although racial disparities in the quality of Surgical care are well described, the impact of socioeconomic status on operative Mortality is relatively unexplored.Methods:We used Medicare data to identify all patients undergoing 1 of 6 common, high risk Surgical procedures between 1999 an
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Race and Surgical Mortality in the United States
Annals of surgery, 2006Co-Authors: F. Lee Lucas, Therese A. Stukel, Andrea E. Siewers, Arden M. Morris, John D BirkmeyerAbstract:Objective: This study describes racial differences in postoperative Mortality following 8 cardiovascular and cancer procedures and assesses possible explanations for these differences. Summary Background Data: Although racial disparities in the use of Surgical procedures are well established, relationships between race and operative Mortality have not been assessed systematically. Methods: We used national Medicare data to identify all patients undergoing one of 8 cardiovascular and cancer procedures between 1994 and 1999. We used multiple logistic regression to assess differences in operative Mortality (death within 30 days or before discharge) between black patients and white patients, controlling for patient characteristics. Adding hospital indicators to these models, we then assessed the extent to which racial differences in operative Mortality could be accounted for by the hospital in which patients were cared for. Results: Black patients had higher crude Mortality rates than white patients for 7 of the 8 operations, including coronary artery bypass, aortic valve replacement, abdominal aortic aneurysm repair, carotid endarterectomy, radical cystectomy, pancreatic resection, and esophagectomy. Among these 7 procedures, odds ratios of Mortality (black versus white) ranged from 1.23 (95% confidence interval, 1.18–1.29) for CABG to 1.61 (95% confidence interval, 1.28–2.03) for esophagectomy. Adjusting for patient characteristics had modest or no effect on odds ratios of Mortality by race. However, there remained few clinically or statistically significant differences in Mortality by race after we accounted for hospital. Hospitals that treated a large proportion of black patients had higher Mortality rates for all 8 procedures, for white as well as black patients. Conclusions: Black patients have higher operative Mortality risks across a wide range of Surgical procedures, in large part because of higher Mortality rates at the hospitals they attend.
Torstein R. Meling - One of the best experts on this subject based on the ideXlab platform.
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Craniotomy for Intracranial Tumors: Role of Postoperative Hematoma in Surgical Mortality
Tumors of the Central Nervous System, 2013Co-Authors: Torstein R. Meling, Benjamin Lassen, Eirik HelsethAbstract:Radical surgery within safe limits is the cornerstone of brain tumor treatment, not only to provide symptom relief, improved quality of life, smaller tumor burden for other treatment modalities and improved survival, but also to establish an exact tissue diagnosis. However, craniotomies are not without inherent risks, be it Surgical Mortality, postoperative hematomas or infections. With respect to intracranial hematomas, the consequences are often devastating, with reported Mortality rates of 30 % and a significant neurological morbidity rate. In a recent large series, the Surgical Mortality, defined as death within 30 days of surgery, was 2.3 % (n = 60) and the cause of death was postoperative hematomas in 21 cases (35.0 %). Independent risk factors were age > 60 (OR 2.43 95 % CI (1.35, 4.39), p < 0.001), whereas neither sex, resection versus biopsy, primary versus secondary craniotomy, nor tumor type were significantly associated with risk of developing postoperative hematoma.
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Surgical Mortality and selected complications in 273 consecutive craniotomies for intracranial tumors in pediatric patients.
Neurosurgery, 2012Co-Authors: Benjamin Lassen, Eirik Helseth, Pål Rønning, Arild Egge, Bernt J. Due-tønnessen, Torstein R. MelingAbstract:BACKGROUND In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates. Contemporary reports on complications following craniotomy for tumor resection in pediatric patients are scarce. OBJECTIVE To study the Surgical Mortality and rate of hematomas, infections, meningitis, infarctions, and cerebrospinal fluid (CSF) leaks, as well as neurological morbidity, after craniotomy for pediatric brain tumors in a large, contemporary, single-institution consecutive series. METHODS All pediatric patients (< 18 years) from a well-defined population of 3.0 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital, Rikshospitalet, during 2003 to 2009 were included. The patients were identified from our prospectively collected database, and all charts were reviewed to validate the database entries. RESULTS Included in the study were 273 craniotomies, performed on 211 patients. Mean age was 8.5 years (range, 0-18). Follow-up was 100%. One hundred ninety-nine cases (72.9%) were primary craniotomies, while 74 cases (27.1%) were secondary craniotomies. Surgical approach was supratentorial in 194 (71.1%) and infratentorial in 79 (28.9%). Surgical Mortality within 30 days was 0.4% (n = 1). Complication rates were intracerebral hemorrhage 0.4%, chronic subdural hematoma 1.1%, meningitis 1.8%, cerebral infarctions 1.5%, and postoperative CSF leak 7.3%. Neurological deficit rates were no change or improvement 87.2%, minor or moderate new deficits 9.5%, and severe new neurological deficits 2.9%. CONCLUSION Overall, the complication rates are low and compare favorably with similar data from adult series. The authors' data could be used as a baseline for future studies.
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Surgical Mortality at 30 days and complications leading to recraniotomy in 2630 consecutive craniotomies for intracranial tumors.
Neurosurgery, 2011Co-Authors: Benjamin Lassen, Eirik Helseth, Pål Rønning, David Scheie, Tom Børge Johannesen, Jan Mæhlen, Iver A. Langmoen, Torstein R. MelingAbstract:Background In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates. Objective To study the Surgical Mortality and rate of reoperations for hematomas and infections after intracranial surgery for brain tumors in a large, contemporary, single-institution consecutive series. Methods All adult patients from a well-defined population of 2.7 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital from 2003 to 2008 were included (n = 2630). The patients were identified from our prospectively collected database and their charts studied retrospectively. Follow-up was 100%. Results The overall Surgical Mortality, defined as death within 30 days of surgery, was 2.3% (n = 60). The Mortality rates for high- and low-grade gliomas, meningiomas, and metastases were 2.9%, 1.0%, 0.9%, and 4.5%, respectively. Age >60 (odds ratio 1.84, P 60 was significantly correlated to increased risk of postoperative hematomas (odds ratio 2.43, P Conclusion The Surgical Mortality within 30 days of surgery was 2.3%, with age >60 and biopsy vs resection being the 2 factors significantly associated with increased Mortality. Postoperative hematomas caused about one third of the Surgical Mortality.
Eirik Helseth - One of the best experts on this subject based on the ideXlab platform.
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Craniotomy for Intracranial Tumors: Role of Postoperative Hematoma in Surgical Mortality
Tumors of the Central Nervous System, 2013Co-Authors: Torstein R. Meling, Benjamin Lassen, Eirik HelsethAbstract:Radical surgery within safe limits is the cornerstone of brain tumor treatment, not only to provide symptom relief, improved quality of life, smaller tumor burden for other treatment modalities and improved survival, but also to establish an exact tissue diagnosis. However, craniotomies are not without inherent risks, be it Surgical Mortality, postoperative hematomas or infections. With respect to intracranial hematomas, the consequences are often devastating, with reported Mortality rates of 30 % and a significant neurological morbidity rate. In a recent large series, the Surgical Mortality, defined as death within 30 days of surgery, was 2.3 % (n = 60) and the cause of death was postoperative hematomas in 21 cases (35.0 %). Independent risk factors were age > 60 (OR 2.43 95 % CI (1.35, 4.39), p < 0.001), whereas neither sex, resection versus biopsy, primary versus secondary craniotomy, nor tumor type were significantly associated with risk of developing postoperative hematoma.
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Surgical Mortality and selected complications in 273 consecutive craniotomies for intracranial tumors in pediatric patients.
Neurosurgery, 2012Co-Authors: Benjamin Lassen, Eirik Helseth, Pål Rønning, Arild Egge, Bernt J. Due-tønnessen, Torstein R. MelingAbstract:BACKGROUND In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates. Contemporary reports on complications following craniotomy for tumor resection in pediatric patients are scarce. OBJECTIVE To study the Surgical Mortality and rate of hematomas, infections, meningitis, infarctions, and cerebrospinal fluid (CSF) leaks, as well as neurological morbidity, after craniotomy for pediatric brain tumors in a large, contemporary, single-institution consecutive series. METHODS All pediatric patients (< 18 years) from a well-defined population of 3.0 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital, Rikshospitalet, during 2003 to 2009 were included. The patients were identified from our prospectively collected database, and all charts were reviewed to validate the database entries. RESULTS Included in the study were 273 craniotomies, performed on 211 patients. Mean age was 8.5 years (range, 0-18). Follow-up was 100%. One hundred ninety-nine cases (72.9%) were primary craniotomies, while 74 cases (27.1%) were secondary craniotomies. Surgical approach was supratentorial in 194 (71.1%) and infratentorial in 79 (28.9%). Surgical Mortality within 30 days was 0.4% (n = 1). Complication rates were intracerebral hemorrhage 0.4%, chronic subdural hematoma 1.1%, meningitis 1.8%, cerebral infarctions 1.5%, and postoperative CSF leak 7.3%. Neurological deficit rates were no change or improvement 87.2%, minor or moderate new deficits 9.5%, and severe new neurological deficits 2.9%. CONCLUSION Overall, the complication rates are low and compare favorably with similar data from adult series. The authors' data could be used as a baseline for future studies.
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Surgical Mortality at 30 days and complications leading to recraniotomy in 2630 consecutive craniotomies for intracranial tumors.
Neurosurgery, 2011Co-Authors: Benjamin Lassen, Eirik Helseth, Pål Rønning, David Scheie, Tom Børge Johannesen, Jan Mæhlen, Iver A. Langmoen, Torstein R. MelingAbstract:Background In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates. Objective To study the Surgical Mortality and rate of reoperations for hematomas and infections after intracranial surgery for brain tumors in a large, contemporary, single-institution consecutive series. Methods All adult patients from a well-defined population of 2.7 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital from 2003 to 2008 were included (n = 2630). The patients were identified from our prospectively collected database and their charts studied retrospectively. Follow-up was 100%. Results The overall Surgical Mortality, defined as death within 30 days of surgery, was 2.3% (n = 60). The Mortality rates for high- and low-grade gliomas, meningiomas, and metastases were 2.9%, 1.0%, 0.9%, and 4.5%, respectively. Age >60 (odds ratio 1.84, P 60 was significantly correlated to increased risk of postoperative hematomas (odds ratio 2.43, P Conclusion The Surgical Mortality within 30 days of surgery was 2.3%, with age >60 and biopsy vs resection being the 2 factors significantly associated with increased Mortality. Postoperative hematomas caused about one third of the Surgical Mortality.
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Surgical Mortality and complications leading to reoperation in 318 consecutive posterior decompressions for cervical spondylotic myelopathy
Acta neurologica Scandinavica, 2010Co-Authors: Charlotte Marie Halvorsen, Pål Rønning, Bjarne Lied, Marianne Efskind Harr, Jarle Sundseth, Frode Kolstad, Eirik HelsethAbstract:Halvorsen CM, Lied B, Harr ME, Ronning P, Sundseth J, Kolstad F, Helseth E. Surgical Mortality and complications leading to reoperation in 318 consecutive posterior decompressions for cervical spondylotic myelopathy. Acta Neurol Scand: 2011: 123: 358–365. © 2010 John Wiley & Sons A/S. Objective – To determine Surgical Mortality, incidence of surgery-related neurological deterioration and incidence of postoperative infection or hematoma requiring reoperation in a consecutive series of 318 patients Surgically treated with laminectomy or laminoplasty for cervical spondylotic myelopathy (CSM). Materials and methods – This is a retrospective study of 318 consecutive patients treated with laminectomy or laminoplasty for CSM at Oslo University Hospital in the time period 2003–2008. The defined neuroSurgical catchment area for OUS is the southeast region of Norway with 2.7 mill inhabitants. The patient charts were systematically reviewed, focusing primarily on operative notes, postoperative (po) complications, such as po deterioration of neurological function, po hematoma and po infection and neurological function at most recent follow-up. Results – The mean age was 64 years (range 29–90 years). Laminectomy was performed in 310/318 (97.5%) and laminoplasty in 8/318 (2.5%) of the patients. The incidence of laminectomy/laminoplasty for CSM was 2.0/100,000 inhabitants per year. The Surgical Mortality was 0%, and 37 (11.6%) patients had a deterioration of neurological function in the immediate postoperative period. Four (1.3%) patients were reoperated because of po hematoma. We found a statistically significant association between po hematoma and previous posterior neck surgery and American Association of Anaesthetists (ASA) score. Five (1.6%) patients were reoperated because of postoperative infection. Univariate logistic regression analysis showed a statistically significant association between po infection and the number of levels decompressed. Conclusions – The incidence of laminectomy/laminoplasty for CSM is 2.0/100,000 inhabitants per year. Surgical Mortality, postoperative hematoma and postoperative infection are rare complications of laminectomy/laminoplasty for CSM. Neurological deterioration is not an uncommon complication after posterior decompression for CSM.
Benjamin Lassen - One of the best experts on this subject based on the ideXlab platform.
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Craniotomy for Intracranial Tumors: Role of Postoperative Hematoma in Surgical Mortality
Tumors of the Central Nervous System, 2013Co-Authors: Torstein R. Meling, Benjamin Lassen, Eirik HelsethAbstract:Radical surgery within safe limits is the cornerstone of brain tumor treatment, not only to provide symptom relief, improved quality of life, smaller tumor burden for other treatment modalities and improved survival, but also to establish an exact tissue diagnosis. However, craniotomies are not without inherent risks, be it Surgical Mortality, postoperative hematomas or infections. With respect to intracranial hematomas, the consequences are often devastating, with reported Mortality rates of 30 % and a significant neurological morbidity rate. In a recent large series, the Surgical Mortality, defined as death within 30 days of surgery, was 2.3 % (n = 60) and the cause of death was postoperative hematomas in 21 cases (35.0 %). Independent risk factors were age > 60 (OR 2.43 95 % CI (1.35, 4.39), p < 0.001), whereas neither sex, resection versus biopsy, primary versus secondary craniotomy, nor tumor type were significantly associated with risk of developing postoperative hematoma.
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Surgical Mortality and selected complications in 273 consecutive craniotomies for intracranial tumors in pediatric patients.
Neurosurgery, 2012Co-Authors: Benjamin Lassen, Eirik Helseth, Pål Rønning, Arild Egge, Bernt J. Due-tønnessen, Torstein R. MelingAbstract:BACKGROUND In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates. Contemporary reports on complications following craniotomy for tumor resection in pediatric patients are scarce. OBJECTIVE To study the Surgical Mortality and rate of hematomas, infections, meningitis, infarctions, and cerebrospinal fluid (CSF) leaks, as well as neurological morbidity, after craniotomy for pediatric brain tumors in a large, contemporary, single-institution consecutive series. METHODS All pediatric patients (< 18 years) from a well-defined population of 3.0 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital, Rikshospitalet, during 2003 to 2009 were included. The patients were identified from our prospectively collected database, and all charts were reviewed to validate the database entries. RESULTS Included in the study were 273 craniotomies, performed on 211 patients. Mean age was 8.5 years (range, 0-18). Follow-up was 100%. One hundred ninety-nine cases (72.9%) were primary craniotomies, while 74 cases (27.1%) were secondary craniotomies. Surgical approach was supratentorial in 194 (71.1%) and infratentorial in 79 (28.9%). Surgical Mortality within 30 days was 0.4% (n = 1). Complication rates were intracerebral hemorrhage 0.4%, chronic subdural hematoma 1.1%, meningitis 1.8%, cerebral infarctions 1.5%, and postoperative CSF leak 7.3%. Neurological deficit rates were no change or improvement 87.2%, minor or moderate new deficits 9.5%, and severe new neurological deficits 2.9%. CONCLUSION Overall, the complication rates are low and compare favorably with similar data from adult series. The authors' data could be used as a baseline for future studies.
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Surgical Mortality at 30 days and complications leading to recraniotomy in 2630 consecutive craniotomies for intracranial tumors.
Neurosurgery, 2011Co-Authors: Benjamin Lassen, Eirik Helseth, Pål Rønning, David Scheie, Tom Børge Johannesen, Jan Mæhlen, Iver A. Langmoen, Torstein R. MelingAbstract:Background In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates. Objective To study the Surgical Mortality and rate of reoperations for hematomas and infections after intracranial surgery for brain tumors in a large, contemporary, single-institution consecutive series. Methods All adult patients from a well-defined population of 2.7 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital from 2003 to 2008 were included (n = 2630). The patients were identified from our prospectively collected database and their charts studied retrospectively. Follow-up was 100%. Results The overall Surgical Mortality, defined as death within 30 days of surgery, was 2.3% (n = 60). The Mortality rates for high- and low-grade gliomas, meningiomas, and metastases were 2.9%, 1.0%, 0.9%, and 4.5%, respectively. Age >60 (odds ratio 1.84, P 60 was significantly correlated to increased risk of postoperative hematomas (odds ratio 2.43, P Conclusion The Surgical Mortality within 30 days of surgery was 2.3%, with age >60 and biopsy vs resection being the 2 factors significantly associated with increased Mortality. Postoperative hematomas caused about one third of the Surgical Mortality.
Guy J. Maddern - One of the best experts on this subject based on the ideXlab platform.
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Factors affecting Surgical Mortality of oral squamous cell carcinoma resection.
International journal of oral and maxillofacial surgery, 2020Co-Authors: Y.l.r. Ong, D. Tivey, L. Huang, P. Sambrook, Guy J. MaddernAbstract:Abstract Survival rates for oral squamous cell carcinoma (OSCC) has remained stagnant in recent years and improving Surgical Mortality could be an avenue to enhance outcomes. This systematic review aims to identify the causes of mortalities, determine both the modifiable and non-modifiable factors involved and target a reduction in postoperative 30-day Mortality. In May 2019, a comprehensive search of key databases including PubMed, EMBASE, Cochrane Library was conducted. Blinded selection by two researchers identified papers that included participants who received oral squamous cell carcinoma resection and suffered an in-hospital or 30-day Mortality. Selection identified two relevant papers that meet the inclusion criteria. One study had one death in its population sample but only had the cause of death described. Another study had an overall Surgical Mortality rate of 1% in a population of 21,681. Patients with multiple factors had the highest Mortality rates; 4.6% in patients >85 years old and have a T4 diagnosis, 3.9% in patients with a Comorbidity Index ≥1 and a T4 diagnosis. These studies did not determine relationships between factors and causes of death. There are significant knowledge gaps in the literature, that can be addressed through further population analysis studies.
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National Surgical Mortality audit may be associated with reduced Mortality after emergency admission.
ANZ journal of surgery, 2017Co-Authors: Andreas Kiermeier, Wendy Babidge, Guy J. Maddern, Glenn A. J. Mcculloch, David A. K. Watters, R. James AitkenAbstract:Background The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related Mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established Mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in Mortality was observed across Australia. Method The AIHW collects procedure and outcome data for all Surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in Surgical Mortality. Results Over the 8 years Surgical admissions increased by 23%, while Mortality fell by 18% and the Mortality per admission fell by 33% (P < 0.0001). A similar decrease was seen in all regions. The Mortality reduction was overwhelmingly observed in elderly patients admitted as an emergency. Conclusion The commencement of this nation-wide Mortality audit was associated with a sharp decline in perioperative Mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced Mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes.
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No weak days? Impact of day in the week on Surgical Mortality
ANZ journal of surgery, 2015Co-Authors: Animesh A. Singla, Gordon S. Guy, Wendy Babidge, John Field, Guy J. MaddernAbstract:Background Studies show increased rates of Mortality for admissions on the weekend (WE) versus the weekday (WD). However, scepticism exists of this so-called ‘weekend effect’ on patient outcome. It remains poorly investigated, particularly the timing of the day of surgery and post-operative outcomes. A UK study found higher odds of death when operated on Friday and the WE, versus WD. This relationship was investigated by interrogating the Australian and New Zealand Audit of Surgical Mortality database. Methods A standardized tool is used to collect data after every Surgical death. Data in this retrospective cohort study from participating private and public hospitals in Australia on elective and emergency operations were extracted and included 7718 patients who had a Surgical procedure within 30 days of admission and who subsequently died. A proxy measure of early Surgical Mortality, namely odds of dying within the first 48 h following surgery, was used to compare Surgical Mortality across days of the week. Results Unadjusted and adjusted odds of early Surgical Mortality were higher on the WE compared to WD, unadjusted and adjusted OR 1.30 (P < 0.001) and 1.19 (P = 0.026), respectively. When separated by day of week, there was a trend for higher Surgical Mortality on Friday, Saturday and Sunday versus all other days, although this did not reach statistical significance. ASA grade and specialty of surgery were important predictors of outcome. Conclusion There appears to be an association between day of surgery and Surgical outcome. The exact cause and contributing factors requires further investigation.
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The Australian and New Zealand Audit of Surgical Mortality-birth, deaths, and carriage.
Annals of surgery, 2015Co-Authors: R. S. Raju, Gordon S. Guy, A. J. Majid, Wendy Babidge, Guy J. MaddernAbstract:Objective:This article outlines the formation of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) and describes its objectives, governance, functioning and challenges.Background:A nationwide audit of Surgical Mortality provides an overview of the leading causes of death in patient
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Victorian Audit of Surgical Mortality is associated with improved clinical outcomes.
ANZ journal of surgery, 2014Co-Authors: C. Barry Beiles, Claudia Retegan, Guy J. MaddernAbstract:Background Improved outcomes are desirable results of clinical audit. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM) and the Victorian Admitted Episodes Dataset (VAED) to highlight specific areas of clinical improvement and reduction in Mortality over the duration of the audit process. Methods This study used retrospective, observational data from VASM and VAED. VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Aggregated VAED data were supplied by the Victorian Department of Health. Assessment of outcomes was performed using chi-squared trend analysis over successive annual audit periods. Because initial collection of data was incomplete in the recruitment phase, statistical analysis was confined to the last 3-year period, 2010–2013. Results A 20% reduction in Surgical Mortality over the past 5 years has been identified from the VAED data. Progressive increase in both surgeon and hospital participation, significant reduction in both errors in management as perceived by assessors and increased direct consultant involvement in cases returned to theatre have been documented. Conclusions The benefits of VASM are reflected in the association with a reduction of Mortality and adverse clinical outcomes, which have clinical and financial benefits. It is a purely educational exercise and continued participation in this audit will ensure the highest standards of Surgical care in Australia. This also highlights the valuable collaboration between the Victorian Department of Health and the RACS.