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Validity of publishing hospital mortality rates questioned

Published on September 25, 2007 at 1:56 AM · No Comments

A previous study of mortality rates for congenital heart surgery used routinely available hospital data that were misleading, according to a report published on bmj.com which questions the validity of such data being made public.

Professor Westaby and colleagues found the system of information gathering used in the study had underestimated the number of infant deaths. In the previous BMJ study, published in 2004, Oxford had been singled out as having significantly higher mortality than the national average for open heart surgery on infants. Yet this new paper, using data from a different source - the Central Cardiac Audit Database - shows that the hospital's mortality statistics were not actually different from the mean for all the centres (10 percent compared to 8 percent between 2000 and 2002).

The authors looked at a report from the ‘Dr Foster' unit at Imperial College which was published in the wake of the inquiry into the Bristol congenital heart surgery deaths. That inquiry, which drew widespread publicity and had a profound effect on surgical practice in the UK, used Hospital Episode Statistics (HES) to compare mortality rates among cardiac surgical units across the country. The 2004 study by Dr Aylin described these mortality statistics.

The authors of the current study compared the mortality rates reported by the administrative HES database and an alternative system, the clinically based Central Cardiac Audit Database, for infants under 12 months undergoing cardiac operations. The statistics were gathered between 1st April 2000 and 31st March 2002.

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