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

Audit Clinical Director, Mr James Aitken, noted that based on Western Australia’s population data from the Australian Bureau of Statistics, the number of deaths under a surgeon per 100,000 population in 2019 was the lowest to date, and a relative decrease of almost 40 per cent in the rate of deaths under a surgeon per 100,000 population over the past eighteen years.

“This is an example that demonstrates the value of the audit and how a relatively modest investment can lead to improved outcomes,” Mr Aitken said.

The report, which was released today, confirmed the previously observed trend in the number of patients who did not receive DVT prophylaxis. This steadily increased between 2015 and 2018 (17.4 per cent to 21.1 per cent), before rising sharply again to 26.1 per cent of cases in 2019.

“Most patients who die after surgery are elderly and underwent at least one major, high-risk operation.

“Whilst there may be many appropriate reasons to withhold DVT prophylaxis, the increasing trend is not what would be expected. Furthermore, previous random checks by WAASM, supported by peer reviewed publications, show that DVT prophylaxis is very frequently imperfectly delivered.

“Proper DVT prophylaxis is an important part of patient care and there is good reason for WA to study this in greater detail, and for further guidance to be provided.”

“The audit has also been closely tracing any impact from the COVID-19 pandemic. This year’s audit figures do not capture the impact of COVID-19, but anecdotally current data suggests a fall in deaths. Some of this will be secondary to fewer incidences of major trauma cases and the reduction of elective surgery, but the full picture will not be clear until later this year.

“International data suggests that previous COVID-19 infection may have adverse long-term health implications, and if correct, elective surgery in previously infected patients may carry increased risk. It may be several years before the full surgical impact of COVID-19 is understood and the audit will play an important role in providing the data that will help us understand this.”

Access the 2020 WAASM Report.


Managed by the Royal Australasian College of Surgeons and funded by the Western Australian Department of Health, the WAASM involves the clinical review of all cases where patients have died while under the care of a surgeon 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.