New Report Shows Alarming Variation in Survival Rates for High-Risk Surgeries in U.S. Hospitals

March 12, 2015

Nonprofit hospital watchdog The Leapfrog Group today released its report, “Predicting Patient Survival of High-Risk Surgeries,” which shows that across U.S. hospitals, the survival rates for four high-risk procedures varies significantly and that most hospitals surveyed do not meet Leapfrog’s standard for each procedure. The results, as analyzed by Castlight Health, demonstrate that the choice of hospital for these operations can mean the difference between life and death.

The in-depth examination looked at survival rates of four high-risk surgeries, including: removing all or part of the pancreas (pancreatectomy), removing all or part of the esophagus (esophagectomy), repair of the major vessel supplying blood to the body (abdominal aortic aneurysm or AAA) and replacement of the aortic valve in the heart (AVR).

Only 17 percent of surveyed hospitals fully meet Leapfrog’s standard for AVRs, approximately 30 percent meet the standard for esophagectomies and AAA repairs, and 42 percent meet Leapfrog’s standard for pancreatectomies.


Additional key findings for each high-risk procedure include:

  • Pancreatectomy: This surgery to remove all or part of the pancreas has the most significant variance in survival rate by hospital, at 19 percent. Predicted survival rates range from 81 to 100 percent.
  • Esophagectomy: Usually performed to treat cancer, an esophagectomy removes all or part of the esophagus. The average survival rate is 90 percent with a variation by hospital of 88 to 98 percent.
  • AAA repair: A surgery to treat an enlarged abdominal aorta, the major blood vessel that supplies blood to the body, has a 13 percent variation in predicted survival rates, which range from 85.7 to 98.9 percent. This variation has increased since 2013.
  • AVR:  This heart surgery treats problems with the heart’s aortic valve, and only 17 percent of hospitals fully met Leapfrog’s standard.

“Every year, millions of Americans undergo surgery, and this report clearly demonstrates that the choice of hospital is one of the most important decisions a patient can make. We strongly encourage consumers to examine their local hospitals’ performance on these high-risk procedures, as the data on survival rates enables patients to gauge their likelihood of surviving each procedure at a given hospital. The difference in lives lost from hospital to hospital can be substantial and this data can’t be accessed anywhere else,” said Leah Binder, president and CEO of Leapfrog. “This report also provides a call to action for hospitals, who must continue to work toward better and more consistent surgical outcomes.”

“The frequency of these high-risk surgical procedures is expected to increase as the U.S. population ages, making the report findings that much more important,” said Jennifer Schneider, M.D., M.S., Chief Medical Officer for Castlight Health. “Beyond the devastating personal and emotional toll of a poor outcome on patients and providers, there is the notable financial burden on the U.S. health care system when less-than-optimal care is delivered. By every measure, these findings warrant attention and immediate action.”

The complete report on High-Risk Procedures is available here.

Today’s report is the second in a series of six reports examining key quality and safety measures at hospitals nationwide, based on data taken from the 2014 Leapfrog Hospital Survey of 1,501 U.S. hospitals and analyzed by Castlight Health. The first report on maternity care, as well as future publications in the report series, are also available.


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