In-hospital deaths as fraction of all deaths within 30 days of hospital admission for surgery: analysis of routine statistics

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Abstract
Death rates after surgical care are increasingly analysed to estimate prognosis and for clinical audit and quality assessment. Expectations are growing among health professionals and the public that hospitals will know about, and learn from, the death rates of their patients. However, routine statistics commonly provide information only on deaths that occur during the hospital admission in which surgery was done. Rates based on these deaths are conventionally known as in-hospital death rates and are typically analysed as those that occur within 30 days after admission or surgery. Systems of national hospital statistics in England were designed in the 1960s and redesigned in the mid-1980s. 1 2 Hospital statistics are not linked to death certificate data nationally, although this has long been feasible. 3 4 Even the National Confidential Enquiry into Perioperative Deaths, a meticulous ongoing national study …

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