Anesthesia safety: model or myth? A review of the published literature and analysis of current original data.
The Committee on Quality of Health Care in America for IOM anointed the area of anesthesia as a model for safety improvements. This study examines those claims by conducting a literature review of anesthesia-related mortality rates from 1966 to 2000. The author also analyzes recent perioperative mortality data collected from two university-based practices. Results from aggregate data, as well as mortality rates determined by peer review, suggest that, contrary to commonly held beliefs, mortality has remained relatively stable in recent decades. However, considerable variability exists due to different operational definitions and reporting sources. Lagasse, while crediting the field of anesthesiology with many safety advances, concludes that insufficient evidence exists to support the reported decline in anesthesia-related mortality. He suggests that standardization of data collection methods and analysis is needed to effectively identify and measure best practices.