Tuesday 12 December 2017

Experts lock horns over post-surgery death rates

Row erupts after study says risk in Irish hospitals is twice that of UK

Working surgeons (posed stock image)
Working surgeons (posed stock image)
Willie Kealy

Willie Kealy

A major row has broken out between medical experts over death rates in Irish hospitals after surgery.

It involves a clash between Irish, British and European researchers and a 2012 European Surgical Outcomes Study, which found death rates after surgery in hospitals here to be 6.4 per cent.

The death rate was nearly twice that of the UK, provoking major concern. The UK study looked at planned and emergency surgery in Ireland at a number of hospitals during a week in April 2012.

It excluded day case surgery, cardiac surgery, radiological surgery and obstetric surgery. The comparable death rate for the UK was 3.6 per cent.

Now an Irish team has repeated the study and said that if the UK study was true, it would have serious implications for the Irish healthcare system.

In their report just published in the British medical publication, The Lancet, the Irish team said the Irish Surgical Outcomes Study shows a much smaller death rate of 2.5 per cent after surgery.

The Irish study looked at 1,071 patients compared to 856 patients in the British study here.

In the Irish study, 56 patients were admitted to critical care and 66 in the British study.

The Irish team said there were repeated unsuccessful attempts by the Royal College of Surgeons in Ireland and the College of Anaesthetists of Ireland to get access to the European Surgical Outcomes Study data.

The Irish study involved 17 hospitals that had participated in the earlier UK study, and the team said they used the same methodology as the British team.

But the Irish study results have found substantial differences and much fewer deaths.

The Irish team said their findings raise questions about retaining the earlier UK study in the medical research literature.

Ireland is not the only country to challenge the British findings.

In reply, the UK team said the Irish study used a different method and a larger number of patients, resulting in a different death rate estimate.

They said that even the Irish finding of a death rate of 2.5 per cent remains a cause for concern.

The British team said that the lower number of critical care admissions and deaths in the repeat Irish study suggest that the high-risk group was not so strongly represented in the new study.

They said they would share their original data with the Irish team but only if the Irish experts provided a statistical analysis plan.

The British team also said their study did not provide a definitive death rate.

Irish Independent

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