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Surgery for congenital heart conditions in Oxford

BMJ 2005; 330 doi: (Published 10 February 2005) Cite this as: BMJ 2005;330:319
  1. Bruce Keogh, professor of cardiac surgery (
  1. University College London, The Heart Hospital, London W1G 8PH

New report shows that Oxford's mortality is in the middle of the national range

The NHS in the United Kingdom fears another “Bristol,” where preventable or excess adverse outcomes may go undetected and unresolved for a prolonged period. In Bristol, reports of excessive surgical mortality among children having heart surgery in the early 1990s led to an independent public inquiry, which concluded that the mortality in children younger than 1 year who were having open cardiac surgery was unacceptably high.1 In October 2004 the BMJ published an article saying that similar problems may be emerging in relation to surgery for congenital heart disease in Oxford.2 Is this really the case?

The Bristol Royal Infirmary inquiry had explored several sources of data that may have detected this inferior performance, and all were found deficient in one way or another. The UK cardiac surgical register run by the Society of Cardiothoracic Surgeons was not only anonymised, but it was based on diagnosis rather than operation and so could not detect differences in outcome where more than one operation existed to treat a single diagnosis. Hospital episode statistics, compiled from routine administrative data, were also not designed …

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