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January 10, 2014

Risk of Death From... Is...

Image courtesy of noomh / FreeDigitalPhotos.net
When it comes to risk of death from surgical procedures, it is illustrative to compare it to more common experiences.

Patients often become unduly concerned with certain risks including death without any true understanding of how rare the risk may be. Unfortunately, such rare risks may be THE reason why a patient may refuse a needed procedure in the erroneous belief that something rare has an unacceptably high chance of occurring to them.

In such situations, it may be beneficial to compare the chance of a rare risk with more common scenarios that a patient may be more familiar with.

The risk of death is... (In bold are surgical procedures)

Death from major surgery if performed within 30 days after a heart attack 1 in 7
Death from high risk open-heart surgery 1 in 20
Dying on the road over 50 years of driving 1 in 85
Dying from any cause in the next year 1 in 100
Annual risk of death from smoking 10 cigarettes per day 1 in 200
Death from UPPP surgery 1 in 500
ER treatment in the next year after being injured by a can, bottle, or jar 1 in 1,000
ER treatment in the next year after being injured by a bed mattress or pillow 1 in 2,000
Death by an accident at home 1 in 7,100
Death from tonsillectomy 1 in 10,000 - 35,000
Death by an accident at work 1 in 40,000
Death playing soccer 1 in 50,000
Death by murder 1 in 100,000
Being hit in your home by a crashing aeroplane 1 in 250,000
Death by rail accident 1 in 500,000
Being struck by lightning 1 in 10,000,000
Death from a nuclear power accident 1 in 10,000,000

References:
Surgery and the D-Word: Approaching the Topic of Death and Dying with Surgical Patients. J Palliative Care Med 2:108. doi:10.4172/2165-7386.1000108

Risk perception and communication: recent developments and implications for anaesthesia. Anaesthesia 2001;56:745-55.

Risk language and dialects. BMJ 1997;315:939-42.

Safety of Adult Tonsillectomy: A Population-Level Analysis of 5968 Patients. JAMA Otolaryngol Head Neck Surg. 2014 Jan 30. doi: 10.1001/jamaoto.2013.6215.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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