Higher than average death rates among heart patients at Health Sciences Centre, report says

A national report on cardiac care shows that more patients died in the Health Sciences Centre within a month of heart surgery than in other provinces, prompting Newfoundland and Labrador's health minister to order a review.

"We've seen the report and there are actually three indicators that raise flags for us," said John Haggie. "And we're really concerned about it."

The Cardiac Care Quality Indicators Report, released Tuesday, was done by the Canadian Institute for Health Information in collaboration with the Canadian Cardiovascular Society.

It looked at how many patients died in hospital within 30 days of three major cardiac procedures: the insertion of a stent to open blood vessels, coronary artery bypass graft or bypass surgery, and aortic valve replacement.

The report also looked at how many patients were readmitted within 30 days of being sent home. 

Deaths at Health Sciences well above average

According to the numbers in the report, cardiac patients at the Health Sciences Centre in St. John's didn't fare well.

The rate of in-hospital death for patients who had stents inserted was slightly above the Canadian average, but the rates of death for the other two procedures were much higher — the highest in the country.

Over three per cent of the bypass patients died in the hospital within 30 days — more than double the Canadian average of 1.3 per cent.

And 4.7 per cent of patients who had aortic valve replacements at the Health Sciences Centre died, more than three times the Canadian average of 1.3 per cent.

Incomplete data?

Catherine Kells, president of the Canadian Cardiovascular Society and a cardiologist in Halifax, said the data does not factor in other illnesses that the heart patients who died might have had, factors that might have influenced their prognosis.

"When the administrative data recorders recorded the information from the charts, they didn't know that these patients had multiple other co-morbidities, which of course would change their risks," said Kells.

The Health Sciences Centre has changed the way it collects information since it was made aware of the numbers in April, Kells said.

Bigger picture

But Haggie isn't ready to declare the problem solved.

"I think we need to have a review, an external review done of the way the data is collected and what it means for Newfoundland and Labrador but also the program itself and how those two pieces connect together," he said.

I want the people of the province to know and have confidence in the cardiac surgery program.- Jiohn Haggie

Kells is right, he said, in that the data was not reported properly. But there were other issues with the data and with the results in the report that he wants to investigate.

He also said there are footnotes on some of the stats and methodologies which "don't clarify but confuse the issue."

Haggie hopes that specialists from the cardiac centres who had the best results will come to the province and review the program at the Health Sciences Centre, including its data collection.

"Whatever the [data] collection issue, I want to know, and I want the people of the province to know and have confidence in the cardiac surgery program," he said.