The once renowned heart transplant program at Baylor St. Luke’s Medical Center in Houston has seen its performance slip in recent years, to the detriment of its patients, the Houston Chronicle and ProPublica report. The publications teamed up on a deep dive into the center’s sinking survival metrics. The nut ‘graph:
But in recent years, the famed program has performed an outsized number of transplants resulting in deaths or unusual complications, has lost several top physicians and has scaled back its ambition for treating high-risk patients, all the while marketing itself based on its storied past, an investigation by the Houston Chronicle and ProPublica reveals.
It goes on to discuss the survival probability rates at St. Luke’s, based on the Scientific Registry of Transplant Recipients. Whereas the national average for survival one year after a heart transplant is 91 percent, St. Luke’s is at 84.2 percent. That’s despite the fact that the “expected” survival rate for St. Luke’s—a weighted number that takes into account patient and donor characteristics—is all the way up at 91.4 percent.
It’s the gap between the two that drives up St. Luke’s “hazard ratio,” a metric that denotes higher- or lower-than-average failure. 1.00 is average. St. Luke’s has a hazard ratio of 1.79, meaning that a heart transplant patient is at 79 percent higher risk at St. Luke’s than at the average U.S. program.
The numbers are updated twice a year and based on a 30-month period; for these, it spans July 1, 2014 through Dec. 31, 2016.
For comparison, I’ve rounded up the figures for the three heart transplant centers in Dallas-Fort Worth, not including child transplant programs:
Baylor University Medical Center
Number of transplants evaluated: 166
Survival rate after one year: 87.7%
“Expected” survival rate after one year: 89.1%
Hazard ratio: 1.16 (16% higher risk)
UT Southwestern Medical Center
Number of transplants evaluated: 92
Survival rate after one year: 90.2%
“Expected” survival rate after one year: 89.4%
Hazard ratio: .9 (10% lower risk)
Medical City Dallas Hospital
Number of transplants evaluated: 39
Survival rate after one year: 89.7%
“Expected” survival rate after one year: 90.5%
Hazard ratio: 1.08 (8% higher risk)