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Surgical Death Rate for Infants Often Not Disclosed

Jun 5, 2015

The rate of death among children undergoing heart surgery is not disclosed in many hospitals performing such procedures. According to a review conducted by CNN, this information is kept a secret in more than half the hospitals that perform heart surgery in pediatric populations. Heart surgery is performed on roughly 22,000 infants and children each year. Out of 109 hospitals that perform these surgeries, only 60 are transparent about the death rate.

CNN reports that data from the Society of Thoracic Surgeons, the largest professional heart surgeon organization in the country, shows that there is large range in death rates among children undergoing heart surgery at hospitals, from about 1.4 percent to 12.1 percent. The organization says it "considers public reporting an ethical responsibility of the specialty."

"I feel like patients don't know what every physician knows: that there's a tremendous variation in the quality of medical care out there," Dr. Martin Makary said to CNN. "Some surgeons have impeccable records, and some have patterns of complications that are outrageous." Dr. Makary is a professor of surgery at Johns Hopkins University School of Medicine.

Less than one out of three pediatric heart hospitals agreed to disclose death rates when asked by the Society of Thoracic Surgeons. "Patients and their families have the right to know the expected outcomes of operations," said Dr. Jeffrey Jacobs, a professor of cardiac surgery at Johns Hopkins and chair of the Society of Thoracic Surgeons National Database Work Force. "We anticipate that over time, more and more hospitals will publicly report their outcomes." Dr. Jacobs is a leading the movement to increase transparency about death rates with children's heart surgery programs.

Not only is disclosure of death rates important for deciding which hospital is the right choice, Jacobs tells CNN that reporting this information is an actual measure of quality. According to a study published in April by the American Surgical Association, there was a lower death rate for adult heart surgery among hospitals who reported their outcomes compared to those who did not. Among hospitals who do not report death rates, the explanation usually mentions that the death rate may be skewed by the low number of patients undergoing the procedure; one death can cause a large jump in this statistic. "These aren't perfect measures," Dr. Charles Fraser, chief of congenital heart surgery at Texas Children's Hospital in Houston said to CNN. "But at some level you have to say this is the best we have at this point, and you can talk to families and explain what the measures do and don't provide." The Texas Children's Hospital reports its death rates.

Recently, CNN reported that parents of children undergoing heart surgery at St. Mary's Medical Center were frequently not informed about how inexperienced the facility was at these procedures. Since the program began in December 2011, at least eight babies have died. Some parents of the children told CNN that they were lied to about the death rate.

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