study shows location may mean everything when it comes to surgery

To say that the choice of hospital to undergo a surgery “can mean the difference between life and death” may seem a bit disconcerting and perhaps even a bit overly dramatic.

However, that’s exactly what one patient safety advocacy group said in a recently published study, which determined that the survival rates for four high-risk surgical procedures — repair of abdominal aortic aneurysms, esophagectomies, replacement of the aortic valve and pancreatectomies — can differ by upwards of 23 percent depending on the hospital selected by patients.

The study was performed by the Leapfrog Group, which submitted requests to 1,500 hospitals throughout the country for 2013 information about each of these risky surgical procedures, including the number of patient deaths and the number performed.

Once the requested data was collected, the researchers set about looking for any trends. Perhaps not surprisingly, they found that those hospitals that performed far more of these procedures typically performed the best.

The real surprise, however, came when the researchers examined each of the four risky procedures:

  • Abdominal aortic aneurysms: Survival rates were found to vary from 86 percent all the way to 99 percent; the benchmark for quality was chosen by researchers to be 97.3 percent, and 268 of 792 hospitals qualified.
  • Esophagectomies: Survival rates were found to vary from 88 percent all the way to 98 percent; the benchmark for quality was chosen by researchers to be 91.7 percent, and 182 of 535 hospitals qualified.
  • Replacement of the heart’s aortic valve: Survival rates were found to vary from 92 percent all the way to 97 percent; the benchmark for quality was chosen by researchers to be 95.6 percent, and 95 of 544 hospitals qualified.
  • Pancreatectomies: Survival rates were found to vary from 81 percent all the way to 100 percent; the benchmark for quality was chosen by researchers to be 91.3 percent, and 203 of 487 hospitals qualified.

This was certainly a fascinating study that should merit further research into why exactly the rates should be so vastly different for procedures that, while admittedly risky, should still be relatively familiar to surgical teams.

Source: Reuters, “Survival rates for risky surgeries in U.S. vary widely: study,” Sharon Begley, March 12, 2015

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