ArticleThe Medical journal of Australia2025
Non-technical errors associated with deaths in surgical care, Australia, 2012-2019, by surgical specialty (Australian and New Zealand Audit of Surgical Mortality): a retrospective cohort study.
Article in The Medical journal of Australia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- From operating room to leadership room: a systematic review of simulation-based interventions for leadership development in general surgery.BMC medical education · 2026Pooled it
- Potentially-Preventable Deaths Following Colorectal Surgery: A National Retrospective Cohort Study of Surgical Mortality.ANZ journal of surgeryArticle
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11 authors.
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Abstract
objectiveTo compare the frequency of non-technical errors in cases of surgical care-related deaths in Australia, by surgical specialty. STUDY
designRetrospective cohort study; analysis of Australian and New Zealand Audit of Surgical Mortality (ANZASM) data. SETTING,
participantsAll surgical care-related deaths in Australia (except New South Wales), 1 January 2012 - 31 December 2019, that were flagged in ANZASM as associated with adverse events or areas of concern.
main outcome measuresProportions of surgical care-related deaths associated with non-technical errors, overall and by domain (communication/teamwork, decision making, situational awareness, leadership); paired comparisons of likelihood of errors by specialty; change in error proportions during 2012-2019; influence of patient and admission factors on likelihood of non-technical errors.
resultsOf 30 971 surgical care-related deaths reported to ANZASM during 2012-2019, 3695 were flagged with adverse events or areas of concern, including 3422 cases (92.6%) in five surgical specialties: general surgery (1570 deaths), cardiothoracic surgery (626), orthopaedic surgery (510), vascular surgery (385), and neurosurgery (331). The proportions of surgical care-related deaths associated with non-technical errors differed by specialty (range, 52.2% to 68.5%), as did those errors in the domains decision making (range, 52.6% to 66.3%) and situational awareness errors (range, 44.4% to 62.5%). The probability of any non-technical error was greater for cardiothoracic than orthopaedic surgery (adjusted odds ratio [aOR], 1.76; 95% confidence interval [CI], 1.37-2.28), and for general than orthopaedic surgery (aOR, 1.97, 95% CI, 1.59-2.44) or neurosurgery (aOR, 1.47; 95% CI, 1.14-1.90); the probability was lower for orthopaedic than vascular surgery (aOR, 0.54; 95% CI, 0.41-0.72). The proportion of deaths associated with non-technical errors declined over time for general surgery, but not the other four specialties. Differences by patient and admission characteristics in the proportions of cases including non-technical errors were not statistically significant.
conclusionAt least 50% of surgical care-related deaths in five surgical specialties were associated with non-technical errors, and the proportions did not substantially change during 2012-2019. Differences between specialties in the frequency of fatal non-technical error suggest that targeted improvement strategies are needed, but the persistently high frequency for all specialties indicates that systemwide improvement is crucial.
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