Concern Over Child Heart Figures

Children who undergo heart surgery in Scotland are more likely to die than elsewhere in the UK, according to new statistics from a NHS database. The figures showed mortality rates for Scots youngsters were higher than in England and Wales in about two-thirds of heart procedures.

The mortality rate for heart operations at the Yorkhill children’s hospital in Glasgow was twice the UK average. But health experts said the findings had to be treated with caution.

The figures were produced by the Central Cardiac Audit Database (CCAD) and were released to help parents and carers make informed decisions about their child’s care. They showed that in one type of heart operation, 12.5% of Scots patients had died compared to just 1.5% in the rest of the UK over the past five years.

Heart operations on Scottish children take place at the National Paediatric Cardiac Centre at Yorkhill, where an average of 281 cardiac operations are performed on children every year.

According to CCAD, children in Scotland were more likely to die up to 30 days after an operation in 18 out of 30 procedures. The average mortality rate for the UK was 2.2% over this time, compared to 5.4% at Yorkhill.

One of the most common operations, the arterial shunt procedure, had a death rate of 7% in Scotland, compared with a national average of 4.5%. Another operation, PDA surgical ligation, had a death rate of 9% in Scotland compared to 5% elsewhere.

And for aortic balloon valvotomy, in which a balloon is inserted to stretch a narrow valve, the mortality rate at Yorkhill was 12.5% compared with the UK average of 1.5%.

But Dr Adam Bryson, medical director of NHS National Services Scotland, dismissed suggestions that Yorkhill was underperforming and said parents should not be caused any additional alarm by the statistics. He said that the number of children undergoing many heart procedures in Scotland was so small that a single death could represent a large percentage increase.

He added: “We are very happy that the team in Glasgow is performing well. The service is of a high standard and within statistically acceptable standards of performance.”

Dr Bryson said issues of deprivation and the poor general health of babies and children in many areas of Scotland were also a significant factor that had to be taken into account when considering the statistics. “One factor in how well people are able to cope with the trauma of surgery is their general state of health,” he said.

A Scottish government spokeswoman said: “It is very difficult to compare mortality rates between different hospitals because of the complexity of the illness, underlying social circumstances and a variety of other factors.

“Paediatric cardiac mortality is monitored very closely by National Services Scotland. It is also important to note that the results of this survey are based on very small numbers of cases, particularly in Scotland.”