Death rates in babies less than 1year old having cardiac surgery in the early 1990s at the Bristol Royal Infirmary were about double those in other centres, according to an analysis commissioned by the Bristol inquiry.
Reports of high mortality after paediatric cardiac surgery at the Bristol Royal Infirmary from 1991 to 1995 led to an independent public inquiry, which was due to publish its findings as the BMJ went to press. A key question was whether the mortality statistics in Bristol were different from those in other specialist centres. The inquiry commissioned a retrospective analysis of mortality in the United Kingdom to answer this question.
The results (released on the Lancet's website ahead of paper publication) confirmed that mortality at Bristol was higher than at other similar paediatric cardiac centres. For children younger than 1 year, mortality was about twice that of other centres during the years in question.
The findings were based on data from the UK cardiac surgical register (January 1984 to March 1996) and hospital episode statistics (April 1991 to December 1995) for all 12 major centres in the United Kingdom where paediatric cardiac surgery is carried out. The main outcome measure assessed was mortality within 30 days of a cardiac surgical procedure.
There were 19.0 (95% confidence interval 2 to 32) excess deaths among 43 deaths at Bristol, according to data from the cardiac surgical register. The hospital episode statistics showed 24.1 (12-34) excess deaths among 41 deaths recorded.
The lead author of the research, Dr Paul Aylin, from Imperial College School of Medicine, London, said: “Our results suggest that Bristol was an outlier and not merely ‘bottom of the league.’ We do not believe that statistical variation, systematic bias in data collection, case mix, or data quality can explain a divergence in performance of this size.”
The results are available at www.thelancet.com and will be published in the Lancet on 21 July.