Key result
Continuous monitoring of case-mix adjusted mortality using a cumulative risk chart detected adverse trends that crossed 99% control limits, which were missed by annual monitoring.
Population
3983 patients aged 16 and over who had open heart operations at a regional cardiothoracic unit between…
Design
Cohort
Follow-up
30 days
Authors
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Should not yet replace annual monitoring in surgical quality programs; leaves open whether continuous charts improve outcomes.
Observational (n=3,983)
No
Effect estimate: OR 1-1.5
p-value: p=0.18
Continuous monitoring of cumulative risk-adjusted mortality is superior to annual league tables for detecting true changes in surgical performance.
Poloniecki et al. (1998) conducted an observational in Open heart operations (n=3,983). Continuous monitoring of case-mix adjusted mortality vs. Monitoring by calendar year was evaluated on Postoperative mortality in hospital within 30 days (OR 1-1.5, p=0.18). Continuous monitoring of case-mix adjusted mortality using a cumulative risk chart detected adverse trends that crossed 99% control limits, which were missed by annual monitoring.
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