BMJ  2005;330:43 (1 January), doi:10.1136/bmj.330.7481.43-b

Letter

Paediatric cardiac surgical mortality after Bristol

Details of risk adjustment tools were not given

The first 150 words of the full text of this article appear below.

EDITOR—The paper by Aylin et al on paediatric cardiac mortality in England after Bristol provides some interesting and potentially perturbing results.¹ The reduction in paediatric cardiac surgical mortality is encouraging, but the identification of hospitals with excess mortality is worrying.

Since 2003 all paediatric intensive care units in England and Wales have contributed data on all admissions to the paediatric intensive care audit network (PICANet), funded by the Department of Health.² Families of patients treated in paediatric intensive care units in the United Kingdom may be reassured that in the data thus far reported no unit has an unexpectedly high mortality.

The method of analysis used by PICANet may be superficially similar to that used by Aylin et al, but on closer inspection it may not. PICANet produces mortality ratios that are carefully adjusted for the illness severity of children on admission to the unit using published risk . . . [Full text of this article]

Health Services Research, University of Sheffield, Sheffield S1 4DA g.parry@sheffield.ac.uk

Department of Epidemiology and Public Health, University of Leicester, Leicester LE1 6TP

Paediatric Epidemiology Group, University of Leeds, Leeds LS2 9LN

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