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Heart 1999;81:593-597; doi:10.1136/hrt.81.6.593
Copyright © 1999 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 1999;81:593-597 ( June )

Death on the waiting list for cardiac surgery in the Netherlands in 1994 and 1995

J Plompa b, W K Redekopa, F W Dekkera, T R van Geldorpc, M M P Haalebosd, G Jambroesf, J H Kingmab, F Zijlstrae, J G P Tijssena

a Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, Netherlands, b Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands, c Department of Thoracic Surgery, Hospital De Klokkenberg, Breda, Netherlands, d Department of Thoracic Surgery, De Weezenlanden Hospital, Zwolle, Netherlands, e Department of Cardiology, De Weezenlanden Hospital, f Heart and Lung Institute, University Hospital, Utrecht, Netherlands

Correspondence to: Professor Tijssen.

Accepted for publication 14 September 1998

OBJECTIVE---To describe the causes and circumstances of death regarding patients who died in 1994 and 1995 while on a waiting list for cardiac surgery in the Netherlands.
DESIGN---Retrospective multicentre case study.
SETTING---11 Dutch cardiac surgery centres.
PATIENTS---All patients reported as dying while on the waiting list for cardiac surgery in 1994 and 1995. 
MAIN OUTCOME MEASURES---Classification of death by an independent adjudication committee into "erroneously reported", "waiting list related" or "not waiting list related". Death was judged as "waiting list related" if the clinical course would have been substantially different if there had been unrestricted surgical capacity.
RESULTS---138 and 129 deaths were reported in 1994 and 1995, respectively. 43 deaths (16%) were considered as erroneously reported. 181 of the remaining 224 cases were adjudicated as waiting list related. Median time from acceptance for surgery to death was 35 days (interquartile range 14-75 days). 97 of 181 deaths occurred within six weeks following addition to the waiting list. The estimated incidence of death ranged from 1.33 per 1000 patient-weeks during weeks 2-4 to 0.68 per 1000 patient-weeks after 12 weeks.
CONCLUSIONS---The causes and circumstances of death are waiting list related for approximately 100 patients per year in the Netherlands. At least half of the deaths may occur within the first six weeks. Waiting lists for cardiac surgery engender high risks for the patients involved.


Keywords: waiting lists; heart surgery; mortality; coronary bypass surgery

© 1999 by Heart
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