A Study of the Deaths Associated With Anesthesia and Surgery

This study determines as accurately as possible the death rate (and why deaths occurred) attributable to anesthesia whether due to agent or technique or to their misapplications and thus to assess the responsibility of the anesthetist in the total care of the surgical patient when failure occurred. 599548 patients on the surgical services of 10 participating hospitals who received anesthesia were studied. There were 7977 deaths in this group (Table 26). There was also an additional group of patients on the surgical services with some 5727 deaths very largely neonatal who had neither anesthesia nor operation (Table 27). During the 5-year study period the number of anesthesias increased 18%. Those administered by nurses increased by only 3.5% (a relative decrease) while those given by anesthesia residents increased 40%. The single most important technique was inhalation anesthesia; but use of intravenous anesthesia has doubled during the study period. Use of ether as a primary anesthetic agent was steadily increasing while the use of cyclopropane was not rising. Most spinal anesthesia was carried out with tetracaine (Pontocaine) or procaine. Procaine was the most commonly used agent for local or regional anesthesia. In this study the surgical patient had a chance of 1:75 of dying from one cause or another. He also had a chance of 1:95 of dying from the disease which brought him to the hospital. The roles or errors in diagnosis; surgical technique and surgical judgment as well as anesthesia are shown in Tables 26 and 27. Over all anesthesia death rate was 1:1560 (Table 28). A disproportionately high anesthesia death rate was observed among men. Details of these findings are discussed as are findings on muscle relaxants (curare).