Original articleClinical endoscopyAll-cause mortality after first ERCP in England: clinically guided analysis of hospital episode statistics with linkage to registry of death
Section snippets
Hospital episode statistics
All NHS trusts in England submit information to a central data warehouse about each admission (including outpatient procedures coded as elective “day cases”).16 NHS trusts are provider organizations that provide secondary care services at one or more hospital sites. These data, or hospital episode statistics (HES), serve a variety of administrative/accounting purposes and contain a limited clinical dataset including a primary diagnosis and up 13 secondary diagnostic codes recorded at the time
Patient population
ERCPs were coded by 150 acute NHS trusts. We retrieved 37,386 ERCP procedures for 2006 to 2007, of which 410 (1.1%) were excluded owing to invalid data entries (eg, invalid dates or missing data fields). Procedure numbers were similar for 2007 to 2008 (38,108 ERCPs; 518 [1.4%] invalid records). Based on questionnaire feedback, we focused analysis on first ERCP procedures. Within each data year, patients who underwent their first ERCP procedures between July 1 and March 31 were selected
Discussion
This study describes a national linkage analysis of all-cause mortality in patients undergoing first ERCP and the relative influence of simple demographic and clinical variables. Published data on 30-day mortality after ERCP for unselected national samples are limited, although a recent Swedish registry project reported a rate of 5.9% (n = 8088 patients; malignancy in 10.3%).21 This figure is very similar to our finding of 5.3% (n = 40,938 patients; malignancy in 15%).
Study strengths include
Acknowledgments
We thank the British Society of Gastroenterology for facilitating the project; our steering committee (Ewan Wilkinson, Gary Cook, Derek Lowe, Simon Travis, Rob MacAdam, David Fillingham, Ian Barrison, Richard Driscoll); Martin Lombard and Richard Sturgess for helpful discussions; and colleagues from the Information Centre (Martin Orton, Jacqui Bobbi). We are grateful to British Society of Gastroenterology members who responded to our questionnaire.
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DISCLOSURE: This work was funded by the National Health Service Information Centre for Health & Social Care. No other financial relationships relevant to this publication were disclosed.
If you would like to chat with an author of this article, you may contact Dr Bodger at [email protected].