In pure numerical terms, anesthesia-associated mortality has risen
again. The reasons for this are the disproportionate increase in the
numbers of older and multimorbid patients and surgical procedures that
would have been unthinkable in the past. This is the result of a
selective literature review of André Gottschalk's working group at the
Bochum University Hospital in the current issue of
Deutsches Ärzteblatt International.
In the 1940s, anesthesia-related mortality was 6.4/10,000. By
introducing safety standards such as pulse oximetry and capnometry, the
rate was reduced to 0.4/100,000 by the late 1980s. This value still
applies for patients without relevant systemic disease. However,
mortality has risen in patients with relevant comorbidities
(0.69/100,000). Such comorbidities include heart failure, angina
pectoris, chronic renal failure, or severe malignant hypertension.
Because of improved safety standards such patients can have surgery
nowadays -- something that would have been unthinkable in the past owing
to their multimorbidity. Another factor explaining anesthesia-related
mortality is the fact that the proportion of patients who are older than
65 rose in Germany from 28.8% in 2005 to 40.9% in 2009.
/Science Daily/