Performance data and the mortuary register

Objective: To compare departmental records of deaths after cardiac surgery with the hospital's information system. Design: Matched pairs comparisons: (i) historic record compared with curren t record from another source; (ii) contemporary records from different sour ces; and (iii) timed records from different sources. Setting: Regional cardiothoracic units at St George's and St. Thomas's Hosp itals. Subjects: 2664 cardiac surgical operations at St George's between January 1 992 and June 1994, 215 deaths in the cardiac surgery database at St Thomas' s between April 1993 and March 1997, 120 in-hospital deaths received by the mortuary at St George's during June 1999. Main outcome measures: The difference in the number of in-hospital deaths f rom departmental, hospital, and mortuary sources. Results: Four of 2664 operations (0.15%) had been incorrectly coded as leav ing hospital alive. Fewer than 80% of the actual number of deaths after car diac surgery at St Thomas's had been recorded on either the departmental da tabase or the hospital administration system. For 9% of deaths received in the mortuary, it took more than 6 working days for the hospital record to b e updated, and at the time of reporting 1 case had not been updated after 1 4 working days: the date of death was inaccurate in 4/113 (3.5%) of cases. Conclusions: The mortuary staff can contribute to improving the accuracy of body counts. Death rates and performance data should not be published with out statistical peer review.