Mortality data in adult cardiac surgery for named surgeons: retrospective examination of prospectively collected data on coronary artery surgery and aortic valve replacement

Publisher Website
Google Scholar
Abstract
Objectives To present named surgeon mortality for isolated first time coronary artery surgery and aortic valve surgery. Design Retrospective analysis of prospectively collected data. Setting All NHS hospitals undertaking adult cardiac surgeryin north west England. Participants 25 consultant surgeons carrying out coronary arterysurgery and aortic valve replacement between April 2001 andMarch 2004. Main outcome measures Mortality for both operations accordingto surgeon. EuroSCORE to stratify patients into low and highrisk. Results 10 163 patients underwent surgery under 25 surgeons.The average number of patients per surgeon was 363 for coronaryartery surgery and 44 for aortic valve replacement. Seventeenper cent of the patients undergoing coronary artery surgeryand half of those undergoing aortic valve surgery were consideredhigh risk. The average mortality was 1.8% (range 0-3.8%) forcoronary surgery and 1.9% (0-12.5%) for aortic valve surgery.Mortality for all surgeons fell below 99% control limits ofthe national mean for both operations. Conclusions The presented mortality figures for the two cardiacoperations fell within accepted limits for all surgeons. Thedivision of outcomes according to low and high risk patientsis imperfect but may help to inform the public about the complexitiesof this type of analysis and prevent surgeons avoiding highrisk patents who may benefit from an operation.