Surgeon Level Public Reporting of AAA and CEA

The Vascular Society has, for the first time, published details of consultant-level outcomes after vascular surgery. The National Vascular Registry 2013 Report on Surgical Outcomes: Consultant-level Statistics, presents information on the results of surgery for patients who underwent two types of vascular procedures: elective repair of an infra-renal Abdominal Aortic Aneurysm (AAA) and stroke prevention surgery or carotid endarterectomy (CEA).

This information builds on the UK wide quality improvement programmes that vascular surgeons have been running since 2005. The Society has been reporting unit-level outcomes for AAA and CEA and has seen significant improvement in surgical performance in the last eight years. This reporting has led to the rate of mortality after elective infra-renal AAA repair in the UK falling from 7% in 2008 to 2.4% in 2013. This is a direct result of the relentless focus by multi-disciplinary teams (MDT) on outcomes over preceding years.

The audit presents outcomes information for consultants working within the UK. It gives figures for consultants and NHS trusts/ Health Boards. The data reveals that no surgeon had an outcome outside the expected range – so there were no outliers. Data were adjusted to take into account the varying risk profiles of differing patients (this is called “casemix adjustment”). This ensures that surgeons who take on complex, higher risk cases are not unfairly criticised for having higher death rates.