Mortality after surgery in Europe

www.thelancet.com Vol 381 February 2, 2013 369 Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/ six hospitals in Poland to the whole country, as Pearse and colleagues have done, seems inappropriate. We assessed data for 2011 from the database of the National Health Foundation (NHF) in Poland. The database, which is not publicly accessible, includes almost all major and most minor surgical procedures (it does not cover obstetric, radiological, or paediatric procedures, nor the usually minor procedures done privately, but does cover planned 1-day, cardiac, and neurological surgery, which were excluded by Pearse and colleagues). We noted the type of discharge from hospital (in this case “death”), predefi ned in the computer system and reported to the NHF. As shown in the table, the average in-hospital mortality for all surgical procedures in 2011 in Poland was 0·98%—ie, 18 times lower than that shown by Pearse and colleagues. Additionally, we have extracted from the NHF database the data on mortality in the six hospitals in Poland that took part in Pearse and colleagues’ study. In those six hospitals, average in-hospital mortality after all surgical procedures in 2011 was 1·07%, which is very similar to the whole-country rate. We suggest that Pearse and colleagues’ methods are misleading Mortality after surgery in Europe