Post-surgery mortality in Ontario hospitals (2024)

Table of contents

• What is post-surgery mortality?
• What are Ontario hospitals with the lowest post-surgery mortality rates?
• What are Ontario hospitals with the highest post-surgery mortality rates?
• What might a high post-surgery mortality rate mean?
• What might a low post-surgery mortality rate mean?

What is post-surgery mortality?

The post-surgery mortality rate refers to the percentage of patients who die within a specific period after undergoing a surgical procedure. It is a key indicator of patient safety and the quality of surgical care provided by hospitals. Measuring and monitoring post-surgery mortality rates is important for several reasons.

Firstly, it serves as a vital benchmark for evaluating the performance of hospitals and surgical teams. A high post-surgery mortality rate may indicate potential issues with surgical techniques, patient management, or the overall quality of care provided. By tracking these rates over time, hospitals can identify areas for improvement and implement targeted interventions to enhance patient outcomes.

Secondly, monitoring post-surgery mortality rates helps identify trends and patterns in surgical outcomes. Hospitals can analyze variations in mortality rates across different procedures, surgical specialties, and patient populations to identify factors contributing to adverse outcomes. This information can inform decision-making processes, resource allocation, and quality improvement initiatives aimed at reducing mortality rates and improving patient safety.

Additionally, public reporting of post-surgery mortality rates promotes transparency and accountability in healthcare. Patients, families, and referring physicians can use this information to make informed decisions about where to seek surgical care. Hospitals with lower mortality rates may be perceived as safer and more reliable options for surgical procedures, enhancing their reputation and competitiveness in the healthcare market.

Furthermore, measuring and monitoring post-surgery mortality rates is essential for meeting regulatory requirements and accreditation standards. Regulatory agencies and accrediting bodies often require hospitals to track and report surgical outcomes, including mortality rates, as part of their quality improvement and patient safety initiatives. Compliance with these standards demonstrates a commitment to delivering high-quality care and maintaining patient safety standards.

What are Ontario hospitals with the lowest post-surgery mortality rates?

Below are top five hospitals with the lowest post-surgery mortality rates.

• 🥇  Hawkesbury General Hospital, ranked first with a post-surgery mortality rate of 0.6 deaths per 100 major surgical cases, translates to approximately 1 in 167 patients dying.

• 🥈 Brockville General Hospital, ranked second with a post-surgery mortality rate of 0.8 deaths per 100 major surgical cases, equivalent to approximately 1 in 125 patients dying.

• 🥉 Oak Valley Health, securing the third position with a post-surgery mortality rate of 0.8 deaths per 100 major surgical cases, also reflects a low mortality rate, equivalent to approximately 1 in 125 patients dying.

• Muskoka Algonquin Healthcare, ranked fourth with a post-surgery mortality rate of 0.9 deaths per 100 major surgical cases, translates to approximately 1 in 111 patients dying. While slightly higher than the top-ranked hospitals, the mortality rate remains relatively low.

• Joseph Brant Hospital, securing the fifth position with a post-surgery mortality rate of 1.0 death per 100 major surgical cases, equivalent to 1 in 100 patients dying, maintains a commendable mortality rate.

What are Ontario hospitals with the highest post-surgery mortality rates?

Below are top five hospitals with the highest post-surgery mortality rates.

• Norfolk General Hospital has the highest post-surgery mortality rate in the province, with 3.3 deaths per 100 major surgical cases, equivalent to 1 in 33 patients dying.

• Headwaters Health Care Centre, situated in Dufferin County, ranks second with a post-surgery mortality rate of 2.9 deaths per 100 major surgical cases, equivalent to approximately 1 in 34 patients dying.

• Grey Bruce Health Services holds the third position, with a post-surgery mortality rate of 2.6 deaths per 100 major surgical cases, equivalent to approximately 1 in 38 patients dying.

• Thunder Bay Regional Health Sciences Centre maintains the fourth-highest post-surgery mortality rate at 2.6 deaths per 100 major surgical cases, equivalent to approximately 1 in 38 patients dying.

• Peterborough Regional Health Centre ranks fifth with a post-surgery mortality rate of 2.5 deaths per 100 major surgical cases, equivalent to 1 in 40 patients dying.

What might a high post-surgery mortality rate mean?

High post-surgery mortality rates can be attributed to a variety of factors, beginning with the complexity of the surgical procedure itself. Surgeries that involve intricate maneuvers, major organs, or lengthy operation times inherently carry greater risks for complications and mortality. Similarly, patients with underlying health conditions face heightened risks, as conditions such as heart disease, diabetes, or respiratory issues can compromise their ability to withstand surgical stress and recover successfully.

Advanced age is another significant factor contributing to high post-surgery mortality rates. Elderly patients often present with multiple comorbidities and diminished physiological reserves, making them more susceptible to surgical complications and less resilient to the rigors of surgery and postoperative recovery. Additionally, emergency surgeries, which are often performed under urgent circumstances without adequate preoperative preparation, tend to have higher mortality rates due to the increased likelihood of patient instability and complications.

Inadequate preoperative assessment and optimization of patients' health statuses before surgery can also contribute to elevated mortality rates. Insufficient evaluation of risk factors, incomplete medical histories, and failure to optimize comorbidities prior to surgery may lead to avoidable complications and adverse outcomes. Furthermore, surgical complications, both intraoperative and postoperative, significantly impact mortality rates. Factors such as excessive bleeding, organ injury, anesthesia-related adverse events, infections, thromboembolism, and cardiac events can all increase the risk of mortality following surgery.

The experience and skill level of the surgical team also play a crucial role. Inexperienced surgeons or inadequate coordination among team members may result in surgical errors, delayed complication management, and ultimately, higher mortality rates. Additionally, the quality of postoperative care provided to patients significantly influences their outcomes. Suboptimal monitoring, inadequate pain management, delays in recognizing and managing complications, and deficiencies in critical care support can all contribute to adverse outcomes and increased mortality following surgery.

Hospital-related factors, such as resource limitations and staffing shortages, can further exacerbate post-surgery mortality rates. Inadequate ICU capacity, insufficient infrastructure, and other resource constraints may compromise the quality of postoperative care and contribute to higher mortality rates. Addressing these multifaceted factors requires a comprehensive approach that includes thorough preoperative evaluation, meticulous surgical technique, vigilant postoperative monitoring, and optimization of postoperative care protocols to mitigate risks and improve patient outcomes.

What might a low post-surgery mortality rate mean?

Lower post-surgery mortality rates can stem from various factors, including advancements in medical technology and surgical techniques, improved preoperative assessment, and optimization of patients' health statuses, as well as enhanced postoperative care protocols. Additionally, factors such as increased surgeon experience, adherence to evidence-based practices, and robust quality improvement initiatives can contribute to improved patient outcomes and reduced mortality rates following surgery.

However, when assessing post-surgery mortality rates, it's crucial to consider several data issues. Firstly, the accuracy and completeness of data collection regarding surgical procedures and patient outcomes are paramount. Incomplete or inaccurate data can distort results and compromise the reliability of mortality rate calculations. Secondly, variations in patient populations and case mix across different healthcare facilities can impact mortality rates. Accounting for differences in patient demographics, comorbidities, and procedural complexity is necessary when comparing mortality rates between institutions to ensure fair and meaningful comparisons.

Moreover, the duration of postoperative follow-up is significant. Longer follow-up periods may capture more delayed complications and deaths related to the surgical procedure, providing a more comprehensive assessment of mortality outcomes. Additionally, consistency in defining mortality endpoints is crucial for accurate data analysis. Differences in how mortality is defined, such as in-hospital mortality versus 30-day mortality, can lead to discrepancies in reported mortality rates and affect the interpretation of study findings.