Newer heart surgeons as safe as older hands

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Heart patients heading for surgery can be reassured that they are in safe hands with a newly appointed surgeon.

The patient mortality rate among new cardiovascular surgeons is about the same as for their more experienced counterparts, UK researchers report in the British Medical Journal. However, they did observe a “learning curve” effect, with patient mortality rates declining over time for newer surgeons.

Dr. Ben Bridgewater of South Manchester University Hospital and colleagues analysed the outcomes of nearly 19,000 heart surgery patients between 1997 and 2003. Some 5600 of these patients were operated on by 15 surgeons in the first four years after they were appointed.

For newly appointed surgeons, 2.0 percent of patients died, compared with 1.9 percent for established surgeons.

“Our study suggests that patients and hospitals can be reassured that mortality is not higher in patients of newly appointed surgeons,” the authors note.

Overall mortality decreased over the 6 years of the study, the team found, and there was significant improvement over time for new surgeons. “There was a progressive decrease in observed mortality ... from 2.2 percent in the first year to 1.2 percent in the fourth year,” they note.

“There does seem to be quite a big effect there,” Bridgewater told Reuters Health. “It only makes sense that as you get more experienced, you get better at your job.”

There are also implications for other types of surgery, he said. While cardiovascular surgery in the UK is highly monitored and scrutinised, that isn’t the case for all specialties. “I think it likely that these things are quite profound and widespread in other surgical disciplines,” Bridgewater said.

BMJ Online 2004.

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