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1. Risk scoring explained

Heart operations are major procedures with a small but definite risk of death. In general, the lower the death rate, the safer and better is the service, but comparing hospitals' or surgeons’ simple death rates following heart surgery can give a misleading picture. Every patient operated on is different and can have a number of risk factors to be taken into account (like age, unstable angina and chronic pulmonary disease). For surgical units or surgeons that operate on older or sicker (high risk) patients, it is likely that the death rate will be higher than for low risk patients. This potential difference is referred to as ‘casemix’ and needs to be taken into account when comparing outcomes. It is important to compare like with like to avoid misleading comparisons.

For all patients having a heart operation at Papworth Hospital, the risk of not surviving surgery is calculated as a percentage according to the patient's risk factors; this is often referred to as a 'risk score'. We currently use the risk scoring system, EuroSCORE (European System for Cardiac Operative Risk Evaluation). We then compare our actual death rate against that predicted by the scoring system to monitor our cardiac outcomes. To look at the EuroSCORE website please click here.

One important fact to remember is that no risk scoring system is perfect: when applied to an individual patient it only allows an educated estimate of risk.

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