CARDIAC SURGERY, STANDARD OF CARE

It is always good to have outcome data, on treatment methods. I have just read in BBC news, the data published by the British Society of Cardiothoracic Surgery, of their 400,000 operations from 2001 - 2008.

DEATH RATES
Coronary artery bypass surgery alone:
2001: 2.3%
2008: 1.5%
All coronary artery bypass surgery:
2001: 2.6%
2008: 1.7%
Heart valve surgery alone:
2001: 5.2%
2008: 3.5%
Combined valve and coronary artery bypass surgery:
2001: 8.3%
2008: 6.1%

It is good to know. Now we have a benchmark to compare our own standards against that of a developed country. It is important to note that since 2001, in UK, the standard of care has improved significantly. Also, that when we compare surgery, we must always talk about the case mix and the compexity of the surgery. We should not just talk about bypass surgery. It can have so many forms, and with each complexity, the outcome may vary. In fact from 2001-2008, although they were being audited, the UK cardiac surgeons did not shy away from doing complex or more complex cases. ( There is a tendency when doctors outcome are being audited, they will tend to do " safe cases " so that their individual numbers will be good ). They were taking on older patients ( greater than 75yrs old ) regularly ( 20% of the patients were above 75 yrs old ), and still have good results. There were less re-operations too. However, the authors noted that the female gender seem to confer an additional risk. Female patients did not seem to do so well, as it is noted worldwide.
Overall the results from UK are very good and I can only hope that our Malaysian cardiac surgeons will be doing just as well.
I would also like to see similar figures out of UK, USA or Europe, on angioplasty, and see how we compare.