Concern over post-op death rates
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 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."
Professor Bruce Keogh, a heart surgeon and NHS medical director, said: "The NHS is already among the best in Europe for some surgery specialties but these reports are vital as they show surgeons where they need to improve. In heart surgery, greater analysis and transparency of data has seen the NHS lead Europe for its survival rates. The NHS Commissioning Board will examine these studies carefully and work with surgeons to see how we can improve all surgery results further."