Ireland has high post-op death rate

[Posted: Fri 21/09/2012 by Niall Hunter, Editor www.irishhealth.com]

Ireland has one of the highest death rates in patients post-surgery in Europe, a major new study has indicated.

In the study of outcomes for non-cardiac operations in 28 European countries, Ireland was among those countries with poorer outcomes and higher unexplained death rates in patients than most other countries.

Ireland, Poland, Latvia, and Romania are listed as having the highest unexplained post-surgical death rates among European countries. In Ireland, 856 patients were studied, of whom 55 died in hospital, a mortality rate of 6.4%.

This ranked Ireland along with Poland, Latvia, and Romania in having the highest unexplained post-surgical death rate among European countries. Latvia had a death rate post-surgery of 21.5%, Poland's rate was 17.9%, while Romania's was 6.8%.

These death rates took into account adjustment of the figures for 'identified confounding variables', such as urgency and complexity of the surgery carried out, and whether the patients were smokers or had other conditions such as diabetes, all of which which could affect the outcome of an operation.

According to the study results, the UK's post-surgery mortality rate was 3.6%. The lowest death rate recorded was in Iceland, where the death rate post-surgery was only 1.2%.

The researchers, from the European Society of Anaesthesiology and the European Society of Intensive Care Medicine, said Ireland was among the countries with higher unexplained rates of post-operation deaths, using the UK study population as the reference category.

The researchers, whose findings are published in The Lancet, say the results suggest both the need and potential to implement measures to improve post-operative outcomes.

The study, carried out during one week last year, shows that there are startling differences in non-cardiac surgical mortality across European countries. In most cases these were higher than previous national estimates.

The researchers said newer, more cost-effective ways of identifying patients at risk at an early stage post-op must be identified. They said simply providing extra expensive intensive care beds would not solve the mortality problem.

They said no health system in Europe can afford to transfer all surgical patients routinely to intensive care, as is the case with most heart and brain surgery.

While the study does not appear to identify the size of the Irish hospitals included in the Irish cohort of the study, the findings may strengthen the Government's hand in planning to end intermediate and major surgery at smaller hospitals, and carrying out minor surgery only at these hospitals.

The Government's framework for smaller hospital services, which is set to outline which services are to move from smaller hospitals to larger ones, and which services should be available in smaller centres in future, has been delayed by over a year.

cog  Posted: 21/09/2012 10:13

I thought centralisation of services and our Centres of Excellence was going to improve things and make surgery safer? This does not sound like progress to me and it certainly has not saved money. So why did we do it?

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