UK Survival Rates Data

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chrisgreen500

Hi,

I'm sure most of the site users from the UK have heard this in the news. The Healthcare Commission has launched a website giving survival rate data from UK hospitals.

This for me is a very welcome development, particularly as my father is due to have a bypass in the near future.

Follow this link:
http://heartsurgery.healthcarecommission.org.uk/


Regards
Chris
 
I hadn't seen that site before. It was good to see that my surgeon performs well. :) What I found very interesting is the bit where you can calculate your EuroSCORE, that was a bit scary though, I think that I am glad not to have seen it prior to surgery as I don't score well.
 
In this chart the green box shows that the actual rate of survival for this operation is 98.8% (1). In other words 988 out of every 1,000 people treated at this hospital survived their heart surgery and were discharged.

Interesting. This pretty much answers my question of a week or so ago -- what are the duration parameters used in determining "survival rate". This web site narrows it down to a window from surgery up to discharge.
 
It varies from hospital to hospital. The AVR survival rate last year in the hospital where my surgeon works was 100%. Over the past three years it was 98.6%.

To use the site you really ought to know which hospital you are looking at, some are better than others. The catchment area is going to have an effect, a hospital in an affluent area is likely to produce better results than one in a deprived area simply because the patients have a different lifestyle.

Mine serves a population of 3 million and is a specialist tertiary referral centre for all types of adult cardiac and thoracic surgery so is likely to attract more difficult cases.
 
A warning

A warning

Many highly experienced surgeons will have performed far more of the riskier operations, and therefore have lower survival rates.
 
Just look where we are now compared to 50 years ago. Things have improved dramatically. For healthy patients and "routine" surgeries, chances you'd make it to the other side are virtually guaranteed. Open that champagne bottle!
 
Yep

Yep

It is good, aint it? Can only get better as technologies to deposit cells where we wish are developed, and also (this is one I can't wait for!) minature submarine robots are created to do surgery. Combine the two, and you have something that can be inejcted into the bloodstream to repair your damaged valve 100 cells at a time!

Anyway, back onto the topic. The stats should ideally be adjusted to show survival rates vs prior predicted survival rate

For example, if a surgeon saved himself for the really tricky stuff - prior estimated chance of survival 50% - but had an 65% survival rate, then that surgeon is clearly top class

Better, in fact, than one who does easier ops which had 95% "prior to op survival probability" and who managed to get 90% of his patients to survive.

As with all stats, they need interpreting as a spread of data.

Patients should be divided into categories before op representing survivial probability - bands of 5%. So you'd get the 30-34%, 35-39%, 40-44% etc all the way up to 94-99%. This prior prediction should be made by several doctors - you don't want individuals "doing a scotty" and reducing survival estimates for a patient so as to look like a miracle worker!

For each band, it would be useful to then look at both relative numbers of mortality vs survival, and relative ratio.

The ratios are the most telling if there are sufficiently large numbers,
eg. if in the 60-64% band, 20 died but 200 survived, that averages out to 200/220= 91% sucess rate for a 60-64% band (such a surgeon would be a confirmed genius).:D

However, if the same surgeon had done 2 in this band, and both survived, that's a seemingly excellent 100% score - but with only 2 tries, it's early days.

Similarly, if a surgeon had done only 1 in the 30-34% band and that individual died, :eek: you'd think it was a high failure rate, but 1 could very easily be a statistical blip. :confused:

If he had worked his way through 100 operations in the 25-29 band with 30% success, and another hundred in the 35-40% band with 45% success, you'd realise that it was indeed a statistical blip, and that his success with similarly risky bands indicated he was better than average!:rolleyes:

So there we have it, folks. In order to properly evaluate a surgeon, you would need to look at the entire spread of data. Trouble is, I don't know if they record this prior estimate of success anywhere. If they don't, then their data is seriously lacking, and the public can only be confused.

Anyone for Maths? Innit great!
 
St George's have information on their site giving figures for each cardiac surgeon. They estimate the predicted mortality rates and show a graph, the higher the line, the better the performance over the prediction. As they point out, a surgeon with a higher mortality rate might be performing better than one with a lower rate simply because they handle more complex cases.

http://www.stgeorges.nhs.uk/cardiacindex.asp
 
Andyrdj said:
It is good, aint it? Can only get better as technologies to deposit cells where we wish are developed, and also (this is one I can't wait for!) minature submarine robots are created to do surgery. Combine the two, and you have something that can be inejcted into the bloodstream to repair your damaged valve 100 cells at a time!

Kind of makes me not too worried about 20 years down the road.
 
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