What is Mortality & Morbidity?

July 02, 2011


More famously called M&M in the field of medicine. Mortality is self-explanatory, morbidity is complications that occur to patients whether small or big. This is something that we should always evaluate to ensure our standards are upheld and harm to the patients are minimized. The Hippocratic Oath does say Do No Harm to the Patients and I believe this is something that the doctors should believe deeply. Whatever our actions should reflect this oath that we took.

However despite the best intentions some side effects or complications do occur maybe due to the patients’ pre-existing medical condition or the complexity of the surgery. Recently one of my patients had quite a bad sore throat and it made me think. We need to make people more aware of the common complications that can and do occur. I’ll talk about anesthesia since that’s what I do.

With modern advances in medications, monitoring technology, and safety systems, as well as highly educated anesthesia providers, the risk caused by anesthesia to a patient undergoing routine surgery is very small. Mortality attributable to general anesthesia is said to occur at rates of less than 1:100,000. Minor complications occur at predicable rates, even in previously healthy patients. The frequency of anesthesia-related symptoms during the first 24 hours following ambulatory (daycare) surgery is as follows:
 
  • Vomiting - 10-20%
  • Nausea - 10-40%
  • Sore throat - 25%
  • Incisional pain - 30%
Again, pain is not well controlled as we would like them to be. It has a whole list of complications attached to it. We’ll save it for another day. Nausea and vomiting can be minimized with good hydration and use of good prophylactic anti-emetics (a bit expensive but worth all the pennies) such as ondansetron. Sore throat can be minimized if we minimize the use of endotracheal tubes (the plastic tubes that help you breathe during anesthesia). To do this we need to adhere to the fasting guidelines. As a conclusion I think to have a pleasant anesthesia, we both need to play our part. And please, no smoking at least 24 hrs before anesthesia, you’re just multiplying your risks by a factor of 10 if you do.