Bypass Surgery Getting Safer, Study Finds: MDs Becoming More Skilled Doing Operations
Article by Rita Daly, Health Reporter, published in The Toronto Star, October 19, 1999.
The risk of dying from coronary bypass surgery continues to decline even as older and sicker people are being operated on, a new report on cardiac death rates in Ontario shows.
The lower rates are due to more surgeries being done in fewer hospitals, thereby enhancing the skills of cardiac surgeons, and to closer monitoring of outcomes, says the annual report released yesterday by the Institute for Clinical Evaluative Sciences, a government-funded health think-tank.
“This is good news about the quality of cardiac care in the province,” said Barry Monaghan, chair of the Cardiac Care Network, which co-ordinates heart treatment in Ontario.
But again, as in last year’s results, the report does not include patients who also underwent the riskier valve surgery, which could conceivably double the death rate.
“There’s so many types of (heart) valves, and we don’t collect enough data on all the different types of valve patients to be 100 per cent certain every centre is doing the same type,” said Dr. Jack Tu, principal investigator of the report.
His report shows approximately two of every 100 patients died from bypass surgery in 1997-98. A total of 7,500 adults underwent the surgery that year. Similar data has shown a steady decline in the death rates from bypass surgery since the early 1990s.
Bypass surgery has increasingly become a lower-risk operation as surgeons tackle more patients with more complex cases, Tu said.
The report also gives the results for each of the eight regional cardiac centres in Ontario and shows the death rates went down for all except London Health Sciences Centre and Sudbury Regional Hospital. Tu said the differences are “statistically insignificant,” which means that the variation is no greater than that expected by chance alone.
He added all results are close to the provincial average of 1.94 per cent.
Overall differences are very small and the results vary from year to year so you can’t conclude one hospital is the best hospital and everyone should go there,” he added.
Taking into consideration the sickness, age and sex of patients, Toronto General Hospital had the lowest death rate at 1.63 per cent, compared to 1.71 per cent the previous year. The University of Ottawa Heart Institute followed at 1.72 per cent and Kingston General Hospital at 1.95.