Bypass surgery mortality is blunt measure of performance

doi:10.1136/bmj.329.7470.856-a

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Ian S Gilfillan, cardiothoracic surgeon (ian.gilfillan@health.wa.gov.au)

Fremantle Hospital, Fremantle, WA 6160, Australia

EDITOR—Kmietowicz reports that UK heart surgeons are among the best in the world as measured by crude mortality of isolated coronary artery bypass surgery.1 This marker of surgical performance is widespread.

Imagine the following scenario. A patient undergoing isolated bypass grafting has an uneventful procedure. During …