Death rates for emergency surgical admissions vary widely between hospitals

A new study reveals significant variation between hospitals in patient death rates following emergency surgical admissions in England.

The study, published in the British Journal of Surgery, also found that survival rates were higher in hospitals with better resources.

Patients presenting as emergencies account for the majority of deaths associated with general surgery. There is increasing evidence that the quality of care for these high-risk patients is variable across hospitals within the NHS. Such variability in care is likely to be reflected in differences in mortality rates among hospitals.

To investigate, researchers at Imperial College London conducted a national study to quantify and explore variability in death rates among high-risk emergency general surgery patients. Their analysis included 367,796 patients who received care at 145 hospitals from 2000 to 2009.

The researchers found significant variability in death rates within 30 days of admission among patients treated at different hospitals, with rates ranging from 9.2 per cent to 18.2 per cent. This variability in mortality may in part be explained by differences in hospital resources. Specifically, hospitals that had greater numbers of intensive care beds and made greater use of ultrasound and computed tomography scanning tended to have lower mortality rates.

“We do not yet fully understand all the reasons for variable performance, but this study strongly suggests that there is considerable scope for improving the care of emergency surgical patients,” said Omar Faiz, from the Department of Surgery and Cancer at Imperial, who led the study. “The findings may have long term implications with regard to the provision of emergency services and the infrastructure required to support high-risk emergency patients in acute general hospitals.”

The research was supported by the National Institute for Health Research (NIHR) Patient Safety Translational Research Centre at Imperial.

Adapted from a news release by the British Journal of Surgery.

Reference

Faiz et al. Mortality in high-risk emergency general surgical admissions. BJS; Published Online: July 18, 2013 (DOI: 10.1002/bjs.9208).