In March 2015, The New York Times reported on a patient in her 90s who underwent valve replacement surgery complicated by progressive deterioration.1 The surgeons were optimistic that she would recover, recommended aggressive care, and deferred palliative care options until postoperative day 30, by which time the patient had developed sepsis with multiorgan failure. She died on postoperative day 31. Did the surgeons purposefully delay death beyond 30 days? Concerns have been raised that public disclosure of 30-day postoperative mortality as a metric of surgical quality might result in either reluctance of surgeons to operate on high-risk patients or delaying death until after 30 days.
Itani KMF. Validation of the 30-Day Postoperative Mortality Standard and Its Relevance. JAMA Surg. 2016;151(5):423. doi:10.1001/jamasurg.2015.4889