WAASM Clinical Director, Dr James Aitken, noted that while WAASM has previously reported a long-standing downward trend in mortality, an increase in deaths occurring under the care of a surgeon has been observed since the onset of the COVID-19 pandemic.
"It seems the rise is driven by general surgery. This is the largest surgical specialty and accounts for approximately 40 per cent of deaths. There has also been an increase in the number of surgical patients who do not have an operation. This likely reflects the long-term education that WAASM has provided in relation to the avoidance of non-beneficial surgery," said Dr Aitken.
The audit aims to continuously improve surgical care by providing an independent, external clinical review of all patients who die under the care of a surgeon, regardless of whether there was an operation. Reviews are conducted by surgeons who practice in the same specialty but work at a different hospital.
Notably, the WAASM 2025 Report found that many of the clinical management issues identified by reviewers were related to non-technical skills - such as communication and leadership - rather than to the surgical procedures themselves. This finding is echoed by surgeons' comments in surgical case forms: when asked what they would have done differently in hindsight, around 80 per cent pointed to non-technical decisions.
Dr Aitken says these results mirror data from two papers recently published by the Australian and New Zealand Audit of Surgical Mortality.1,2
The report also analyses unexpected surgical deaths occurring in elective patients, those aged 50 years or under, or those admitted to regional hospitals (where complex cases may be best transferred to metropolitan tertiary hospitals).
Dr Aitken emphasised that "patients in Western Australia can be reassured that postoperative deaths in these settings are very uncommon. In particular, the low rate of surgical deaths in regional hospitals indicates that patients are being appropriately managed and, if required, transferred to metropolitan tertiary hospitals".
