Abstract
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.