Singapore Medicines: Heart surgery mortality rates in S'pore comparable to developed countries: MOH

By Julia Ng, Channel NewsAsia

SINGAPORE: A study by Singapore's Ministry of Health (MOH) has found that the mortality rates after heart surgeries in Singapore is comparable to those in developed countries.

It also showed that more heart patients from the National Heart Centre (NHC) survive, compared to those who had their procedures done in Australia, UK, and USA.

Heart surgeries are very common in Singapore. From 2001 to 2005, doctors here carried out 6,060 such procedures, most of them at the National Heart Centre (63.8 percent) and the rest at the National University Hospital (NUH).

On average, the NHC had a heavier caseload, with 773 heart surgeries a year, compared to NUH's 439.

More men compared to women suffered heart failures. Three-quarters (73.4 percent) of those who have undergone heart surgeries were men and most of them (84.8 percent) were above 50 years old.

Heart bypass was the most common heart surgery performed in the NHC and NUH, making up 77.1 percent of the total 6,060 caseload.

Between 2001 and 2005, NHC performed heart bypass surgeries on 2,900 patients and these were highly successful.
Even for high risk patients where a mortality rate of 8.3 percent was predicted, the National Heart Centre scored a remarkably low mortality rate of 4.9 percent.

On average, across the three risk categories of high, medium and low, against a predicted mortality rate of 4.8 percent, heart bypass patients at the Heart Centre enjoyed a low mortality rate of just 1.9 percent.

At NUH, its actual mortality rate of 3.8 percent is also lower than its predicted mortality rate of 4.6 percent.

NUH said its mortality rates are higher than the Heart Centre's because it handled more urgent and emergency cases requiring heart surgeries. This happened when patients urgently needed a heart bypass because their conditions suddenly took a turn for the worse.

Such cases made up 30.2 percent of heart bypass surgeries at NUH, compared to 16.3 percent at the Heart Centre.

NUH Medical Board Chairman, Associate Professor Benjamin Ong told Channel NewsAsia that "many of these patients were referred to NUH from other hospitals and being more ill, the outcomes of their surgeries are often less predictable than those with lower risk and where the procedure is a non-emergency".

Taken together, both the Heart Centre and NUH chalked up an average mortality rate of 2.6 percent for their heart bypasses. This puts them on par with the (unadjusted) mortality rates in Australia, the UK and US.

When all heart surgeries are taken into consideration, the NHC's actual mortality rate of 2.6 percent is also lower than the predicted rate of 5.1 percent, while NUH had an actual mortality rate of 4.4 percent compared to a predicted mortality rate of 4.8 percent. - CNA/ch