Risk-adjusted 90-day mortality rate

What this data shows:

This shows whether the selected surgeon is within the expected range for 90-day mortality following surgery, based on the type of patients this surgeon has seen.

The data is ‘risk adjusted’ to take account of the fact that different surgeons may operate on higher-risk or lower-risk patients (e.g. because of demographics in the patient population they work with).

How the data is gathered:

It should be noted that mortality after hip replacement surgery is influenced by many factors outside the control of the operating surgeon. Case-mix adjustment is a useful tool but as with any methodological approach it cannot account for all differences including those that may be due to random events.

When the data is shown:

It is normal for different clinicians and units to have different results and there is an expected range results can fall in. Sometimes results may fall outside the expected range, which could be an indication that the care provided is either significantly poorer or significantly better than expected. But sometimes these results just happen by chance. Detecting whether a result falls outside the expected range by change or because of a significant reason can be challenging. We want to reduce the times when we identify a unit or individuals results as being outside of the expected range just because of chance.

We can do this by using a wide definition of the expected range. The narrower the definition of the expected range the greater the chance of a result being labelled as outside of it just because of chance.

Audits participating in publication on NHS.uk and MyNHS are asked to use statistical analysis to do this.

You can find out more about this surgeon by clicking on the ‘go to profile’ link on the previous page where there is an additional display of the mortality ratio analysis and information about how to further interpret the data. If you would like to ask your surgeon more about the surgery and the risks involved then please make a note of this question and take it to any relevant appointment with the surgeon or a member of his or her team at the hospital. The consultant orthopaedic surgeon who is responsible for your care is not always the same as the operating surgeon. However, the consultant in charge is responsible for you as the patient.

More information about the data source:

This data represents information entered by each hospital into the NJR. Whilst the NJR takes steps to prevent errors, by validation at the point of data entry, it is possible for data entry errors to occur.

The accuracy and validity of the data relies heavily on the diligence of hospitals and surgeons entering all primary and revision operations. It is the responsibility of the surgeon, healthcare team and hospital to make sure that all cases are registered (known as compliance) and accurate. Participation in the NJR has been mandatory since April 2011 for NHS hospitals and since April 2003 for the independent (private) sector.

The compliance rate for each hospital is presentedon the corresponding hospital profile(s) atwww.njrsurgeonhospitalprofile.org.uk.

Data Source:

National Joint Registry (NJR) database

Data Period:

August 2013- August 2018

Data Supplier:

National Joint Registry for England, Wales and Northern Ireland (NJR)

Further Information:

The NJR has collected information about hip and knee joint replacement procedures since April 2003, ankle joint replacements since April 2010 and elbow and shoulder joint replacements since April 2012. Submission to the NJR is mandatory.

www.njrsurgeonhospitalprofile.org.uk  (for surgeons and hospitals)

www.njrcentre.org.uk      (for more information about the NJR)

www.njrreports.org.uk    (for the NJR’s Annual Report information)