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Post-operative death rates raise concern

  • 3 Comments

Surgery may be leading to twice as many hospital deaths in Europe as has been assumed, a study has shown.

New figures from 500 hospitals in 28 European countries suggest a post-operative mortality rate of 4%. This is more than double previous estimates.

In the UK, the figure was 3.6%, compared with 1.6% from an earlier study which collected data over half as much time.

Death rates varied widely between countries, ranging from 1.2% in Iceland to 21.5% in Latvia.

The new research, published in The Lancet medical journal, involved more than 46,000 general surgery patients whose progress was monitored for up to 60 days.

Study leader Dr Rupert Pearse, from Queen Mary, University of London, said: “Nearly three-quarters of patients who died were never admitted to intensive care.

“Failure to allocate critical care resources to patients at greatest risk of death is a serious public health concern for patients undergoing surgery in Europe.”

The European Surgical Outcomes Study (EuSOS) was conducted in April last year and involved adult patients aged 16 and over undergoing a range of non-heart procedures.

Because the UK had the largest data set, it was used to provide a reference point against which other countries were compared.

The study found that patients in Poland, Latvia, and Romania had the greatest chances of dying.

Within western Europe, the Republic of Ireland had a death rate of 6.4%.

Italy, Belgium, Portugal and France also had a worse record of post-surgery deaths than the UK.

Heart surgery patients who are routinely admitted to critical care have a much lower mortality rate of around 2%.

The scientists wrote: “In our study, the overall crude mortality rate of 4% was higher than anticipated.

“We identified important variations in risk-adjusted mortality rates between nations, and critical care resources did not seem to be allocated to patients at greatest risk of death.

“Our findings raise important public health concerns about the provision of care for patients undergoing surgery in Europe.”

  • 3 Comments

Readers' comments (3)

  • michael stone

    I keep reading about 'evidence based behaviour' in the NHS - and I'm always telling the Hd EoLC at DH 'you don't seem to even collect the right figures, to analyse this'.

    Now, if hospitals don't even manage to satisfactorily count up how many people die after operations (you would think they might be able to notice that), then .......

    And yes, I know that isn't the main thrust of this piece - but it said early on:

    'New figures from 500 hospitals in 28 European countries suggest a post-operative mortality rate of 4%. This is more than double previous estimates.

    In the UK, the figure was 3.6%, compared with 1.6% from an earlier study which collected data over half as much time.'

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  • This data is only of use when it can be related to an individual hospital. The data then needs to be associated with diagnosis/procedure, co-morbidities and age/sex of the patient.

    The Dr. Foster data provided in the UK to those who subscribe will provide information which permits the identification of statistical outliers (compared to other, similar hospitals) and thus facilitate local examination/consideration at an individual hospital. The aim, of course, would be an improved "performance"

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  • 'This is more than double previous estimates.'


    Jenny Jones | 21-Sep-2012 12:16 pm

    True - but one must ask, what was the above referring to when it used the word 'extimates' - estimates of what ?

    Attaching exact numbers to things, makes people believe those things are well understood - you should not attach such numbers, without being very careful !

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