The number of surgery-related deaths in Western Australia has fallen to a record low, according to the latest report of the Western Australian Audit of Surgical Mortality (WAASM).

The 2021 WAASM Report, which presents the outcome of clinical reviews conducted into 2,800 surgical deaths over five years, showed that the number of deaths per 100,000 population has fallen below 20 for the first time since the audit’s inception.

Audit Clinical Director, Mr James Aitken said the reduction over time highlighted the value of the audit process.

“Based on Western Australia’s population, the number of deaths per 100,000 population in 2020 was the lowest to date at 19.9 per 100,000. That is a relative decrease of 13.9 per cent in the rate of deaths per 100,000 population over the past five years”. Since WAASM commenced regular audits, the number of deaths per 100,000 population has almost halved.

“WAASM was the first audit of its kind in Australia when it initially piloted in 2001 under the management of the University of Western Australia.

“In 2005 management of WAASM transferred to RACS and audits now exist in every Australian state and territory. The audit has grown from strength to strength over that time and we now have a 100 per cent participation rate.

“It is an excellent example of how an investment by the WA Department of Health has led to considerably improved outcomes for our health system. We pick up trends as they emerge, which continue to help us adapt and improve the quality of patient care over time”.

The 2021 WAASM Report is the first presentation of this data since the outbreak of COVID-19. While there were initial fears that COVID-19 might adversely impact surgical patients, Mr Aitken said that in Western Australia there have been no deaths due to COVID-19 in a surgical patient.

The only notable change was a fall in deaths after elective General Surgery cases. It is uncertain whether this reflected reduced elective surgery activity or natural annual variation. A clearer picture could emerge when other states report their data for 2020.

“It may be several years before the full surgical impact of COVID-19 is understood. There is evidence that COVID-19 infection has adverse long-term health implications. It remains to be determined if surgery in previously infected patients will increase the risk compared to those with no history of COVID-19. The only way to reduce this risk is to rapidly achieve a fully vaccinated population.”

The 2021 WAASM Report is available on the RACS website.


Managed by the Royal Australasian College of Surgeons and funded by the Western Australian Department of Health, WAASM involves the clinical review of all surgical cases where patients have died and is aimed at the ongoing improvement of surgical care. External clinical reviews are conducted by surgeons who practice in the same specialty but are from a different hospital.