Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb;99(2):161-165.
doi: 10.1308/rcsann.2017.0005. Epub 2017 Jan 10.

Reporting individual surgeon outcomes does not lead to risk aversion in abdominal aortic aneurysm surgery

A Saratzis  1 , A Thatcher  1 , M F Bath  1 , D A Sidloff  1 , M J Bown  1 , J Shakespeare  2 , R D Sayers  1 , C Imray  2
Affiliations

Reporting individual surgeon outcomes does not lead to risk aversion in abdominal aortic aneurysm surgery

A Saratzis et al. Ann R Coll Surg Engl. 2017 Feb.

Abstract

INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) of patients offered elective treatment. METHODS Publically available National Vascular Registry data were used to compare the number of AAAs treated in those centres across the UK that reported outcomes for the periods 2008-2012, 2009-2013 and 2010-2014. Furthermore, the number and characteristics of patients referred for consideration of elective AAA repair at a single tertiary unit were analysed yearly between 2010 and 2014. Clinic, casualty and theatre event codes were searched to obtain all AAAs treated. The results of cardiopulmonary exercise testing (CPET) were assessed. RESULTS For the 85 centres that reported outcomes in all three five-year periods, the median number of AAAs treated per unit increased between the periods 2008-2012 and 2010-2014 from 192 to 214 per year (p=0.006). In the single centre cohort study, the proportion of patients offered elective AAA repair increased from 74% in 2009-2010 to 81% in 2013-2014, with a maximum of 84% in 2012-2013. The age, aneurysm size and CPET results (anaerobic threshold levels) for those eventually offered elective treatment did not differ significantly between 2010 and 2014. CONCLUSIONS The results do not support the assumption that reporting individual surgeon outcomes is associated with a risk averse strategy regarding patient selection in aneurysm surgery at present.

Keywords: Aneurysm; Outcomes; Surgeon specific mortality data; Vascular.

PubMed Disclaimer

References

    1. Fowkes FG, Macintyre CC, Ruckley CV. Increasing incidence of aortic aneurysms in England and Wales. BMJ 1989; : 33–35. - PMC - PubMed
    1. Filipovic M, Goldacre MJ, Roberts SE et al. . Trends in mortality and hospital admission rates for abdominal aortic aneurysm in England and Wales, 1979–1999. Br J Surg 2005; : 968–975. - PubMed
    1. Thompson SG, Ashton HA, Gao L, Scott RA. Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study. BMJ 2009; : b2307. - PMC - PubMed
    1. Waton S, Johal A, Groene O et al. . Outcomes after Elective Repair of Infra-renal Abdominal Aortic Aneurysm. London: RCS; 2013.
    1. Thompson M, Holt P, Loftus I, Forbes TL. Debate: whether abdominal aortic aneurysm surgery should be centralized at higher-volume centers. J Vasc Surg 2011; : 1,208–1,214. - PubMed

LinkOut - more resources