Value of Keeping Records of Mortality

OBJECTIVE: To evaluate treatment and complications which is essential for good medical practice. DESIGN: Prospective audit. SETTING: City hospital, The Netherlands. SUBJECTS: All the patients who died on the surgical ward between 1994 and 1998 and were classified according to four categories of mortality recording. INTERVENTIONS: The causes of death, inaccuracies in treatment and the extent of agreement between premortem and postmortem findings were documented. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: Of the 11,195 patients admitted, 420 (4%) deceased during their hospital stay. Most patients died of the disease with which they presented at admission (n = 176, 42%) or of complications (n = 167, 40%). In 20% (n = 83) of the cases a shortcoming in the clinical course was found. 251 of the 420 patients who died (60%) had a necropsy. 53 of the 251 reports (21%) gave information that could have had an effect on the treatment or the clinical course. CONCLUSIONS: Recording mortality is a way of testing the diagnostic and therapeutic accuracy in our quest for a high quality of care.