Heart surgery: Death rates differ widely between hospitals
Victoria Macdonald
Health and Social Care Editor
Patients who have major artery surgery are twice as likely to die if they are treated at hospitals which rarely perform the operation, an official audit has revealed.
There has been a rapid improvement in the survival rates for major arterial surgery nationwide. In the last four years, the number of fatalities overall have fallen from 7.5 per cent to 2.4 per cent.
However, survival rates still differ widely between hospitals across the UK, and the findings of today’s report by the Royal College of Surgeons have added weight to the argument that it is safer for patients to have more complex surgery at specialist centres rather than at their local hospital.
The report states bluntly: “High volume hospitals deliver better outcomes”.
The audit found that the hospitals with low numbers of patients coming through had an average mortality rate of 4.4 per cent while those that conducted the surgery more regularly had a rate of just 1.9 per cent.
It is the first ever audit of how successful surgery is to treat aortic aneurism, the rupturing of a swelling in the body’s biggest artery.
While it is much rarer in women, it claims the lives of 10,000 men a year in England and Wales. Eighty per cent of patients bleed to death before they make it to hospital.
‘More experienced and more high tech’
Mr Ian Loftus, a consultant vascular surgeon at St George’s Hospital in Tooting, south London, told Channel 4 News that in specialist centres the equipment was often more sophisticated, more ‘high tech’, and the surgeons themselves more experienced.
Read more: Heart attack death rates halve in a decade
What has prevented these sort of services being centralised into more specialist units in the past has been the concern that it will affect the district general hospital losing those services.
‘Travel further’ for safer operations
One health professional said that it was often the local MP standing in the way because they did not want to see any threat to their local hospital.
But Mr Loftus told Channel 4 News that often once the patients saw the figures they decided for themselves that they would prefer to travel further to have a safer operation.
In the operating theatre, he pointed out the state of the art equipment to enable him to mend an aortic aneurysm using keyhole surgery.
He also pointed to a wall of carboard boxes containing £1 million worth of stents, the artificial tubes that are used to help keep arteries open.
“A district general hospital simply would not be able to afford equipment like this,” he said.
And it does bring home the old adage of ‘practice makes perfect’. The more times a surgeon performs an operation, the better he or she becomes (one hopes).