30 day mortality postoperative surgery following oesophagectomy or gastrectomy (risk-adjusted)

What this data shows:

Patients will be better informed of the risk of dying due to complications in the days immediately following oesophago-gastric cancer surgery.

How the data is gathered:

The results show that 30 day mortality rates following oesophago-gastric cancer surgery in England are low, with a mean national of 1.8%. Mortality rates are similar across all surgical centres in England. This measure has been reported for NHS trusts and individual surgeons.

When the data is shown:

When the number of operations is low, rates are often unreliable due to the influence of random events. Therefore outcomes should always be interpreted in combination with the number of procedures performed by the surgeon. Because of the effect of volume on outcomes, we do not report outcomes for surgeons who performed fewer than ten procedures in the reporting period. Some surgeons may operate on patients who are on average sicker than the patients of other surgeons, for whom surgery may be higher risk. Our statistical approach adjusts outcomes to take into account the case mix of patients. Postoperative mortality figures for NHS trusts and surgeons have been adjusted for patient age, sex, site of tumour, performance status, overall fitness (ASA grade), the number of comorbidities, and overall TNM stage. 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 My NHS are asked to use statistical analysis to do this. Where we are able to identify a unit or individuals results as being significantly outside of the expected range using a wide definition, we will show this on the site. We don’t show units or individuals as being outside of the expect range using a narrower definition.

More information about the data source:

The results have been prepared from data submitted to the National Oesophago-gastric Cancer Audit (NOGCA) by NHS hospitals, which have been linked to data from the Office for National Statistics (ONS) Death Register. The reported figures were reviewed and verified by NHS trusts and individual surgeons prior to publication.

Data Source:

NHS trusts providing oesophago-gastric cancer surgery and the Office for National Statistics (ONS)

Data Period:

Patients diagnosed with oesophago-gastric cancer between 1 April 2014 and 31 March 2017

Data Supplier:

National Oesophago-gastric Cancer Audit