Concern over Scarborough and North East Yorkshire Health Care’s operation death rate

8:41am Wednesday 16th June 2010

A NORTH Yorkshire hospital which had a death rate of 28 per cent for a particular operation has said it is unable to comment following a call for an inquiry.

Newly released figures show that operations to correct a swollen artery – or abdominal aortic aneurysm – carried out by Scarborough and North East Yorkshire Health Care had a death rate of 28.6 per cent. The national average is four per cent.

The statistics show that from 2006 to 2008, the authority, which runs hospitals in Scarborough and Bridlington, carried out 14 of the operations, resulting in the deaths of four patients.

It stopped offering the procedures in 2009 after the high death rate was highlighted.

Research has now shown that hospitals which perform only a small number of the operations each year have much higher death rates because they are less practised in the procedure.

But a call for an inquiry by Peter Walsh, the chief executive of Action Against Medical Accidents, into the death rate has gone unanswered. A Scarborough and North East Yorkshire Health Care spokeswoman said she had been unable to get a comment from the medical director.

But she added: “In March 2009 Scarborough and North East Yorkshire Healthcare NHS Trust noted an alert on the Dr Foster monitoring tool against elective aortic aneurysm repair in our hospital.

“We immediately stopped both elective and emergency aortic aneurysm repair and looked further at our mortality rate and volume of surgery.”

At York Hospital, the death rate for the operations was 7.1 per cent for the same period, with 85 people undergoing the operation and six deaths resulting.

Stephen Cavanagh, consultant vascular surgeon at York Hospitals NHS Foundation Trust, said the figures varied from year to year and currently the death rate for this type of procedure was 4.7 per cent.

He also said data submitted to the database was not independently verified and not all units submitted their data in the same way so it was difficult to draw comparisons.

He said: “This is a high-risk procedure. However, the figures provided are not risk-adjusted to take into account people who have more complex aneurysms to fix, or who are particularly unfit, or both.

“The data also does not record the outcome for people who do not undergo surgery.

“By denying high-risk patients surgery, the outcome data figures will be improved, but these untreated patients may rupture their aneurysm, which is often a fatal event with around 75 per cent mortality.

“Ultimately, we try to select patients for surgery to give them the best chance of a successful outcome, and prevent rupture of their aneurysm.

“In keeping with national trends, we are now performing more endovascular aneurysm repairs, with significantly lower mortality rates.”