Heart Disease Deaths Affected By Tables

Fewer people die during major heart surgery when league tables are published showing how well doctors perform, experts said today.

The death rate drops when the public can gain access to relevant data on their operation, a study of almost 26,000 patients found.

In 2001, a report from the public inquiry into the Bristol heart scandal said patients should have access to details of how well a trust and its consultants perform.

Between 30 and 35 children who underwent heart surgery at the Bristol Royal Infirmary between 1991 and 1995 died unnecessarily as a result of “less than adequate care”, the inquiry found.

Today, experts writing in the specialist journal Heart, from the British Medical Journal (BMJ), reinforced these recommendations.

They analysed the work of 30 surgeons in centres carrying out adult cardiac surgery in the northwest of England over an eight- year period.

The units were Blackpool Victoria Hospital, the Cardiothoracic Centre in Liverpool, Manchester Royal Infirmary and South Manchester University Hospital.

Patients undergoing coronary artery surgery for the first time between April 1997 and March 2005 were included in the study.

The researchers divided the eight-year period into surgery carried out before performance tables were published (1997 to 2001), and afterwards (2001 to 2005).

They found that the death rate fell from 2.4% in 1997/08 to 1.8% in 2004/05.

The predicted risk of dying went up from 3% to 3.5% but, equally, more high-risk patients were operated on.

Critics have claimed that public disclosure may lead doctors to take on less-risky cases to improve their figures, but today’s research suggests that is not the case.

“This study has shown that there has been a significant reduction in crude and risk-adjusted mortality since the introduction of public disclosure of cardiac surgical results in the UK,” the authors said.

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