Performing coronary artery bypass surgery on high-risk patients did not adversely affect risk-adjusted mortality rates compared to routine patients (2.94% vs 3.02%, not statistically significant).
Observational
Yes
Does performing coronary artery bypass surgery on high-risk patients adversely affect the risk-adjusted mortality rates for surgeons and hospitals compared to low-risk patients?
Operating on high-risk CABG patients does not adversely affect the risk-adjusted mortality performance metrics for hospitals and surgeons in New York State.
Absolute Event Rate: 2.94% vs 3.02%
p-value: p=not statistically significant
OBJECTIVES: The purpose of this study was to determine whether performing coronary artery bypass surgery on high-risk patients adversely affects the risk-adjusted mortality rates for patients of surgeons and hospitals in New York State compared with the impact of performing surgery on more routine patients. METHODS: Risk-adjusted mortality-rates were calculated for 31 hospitals and 87 surgeons for high-risk (a predicted mortality rate of at least 7.5%) and low-risk patients during the time period 1990 to 1992. RESULTS: The risk-adjusted mortality for all high-risk patients was lower (2.94%) than the risk-adjusted mortality for other patients (3.02%). Fifteen of the 31 hospitals had a lower risk-adjusted mortality for all patients than they did for low-risk patients only, and no differences in either direction were statistically significant. Forty-one of 87 surgeons (47%) had risk-adjusted mortality for all patients that was at least as low as the risk-adjusted mortality for low-risk patients. In general, hospitals and surgeons with the lowest risk-adjusted mortality for all cases also had the lowest risk-adjusted mortality for high-risk cases. CONCLUSIONS: The authors conclude that there is no systematic bias against operating on high-risk coronary artery bypass graft patients in the risk-adjusted performance system in New York.
Hannan et al. (Wed,) conducted a observational in Coronary artery bypass graft surgery. Coronary artery bypass surgery on high-risk patients vs. Coronary artery bypass surgery on low-risk patients was evaluated on Risk-adjusted mortality rate (p=not statistically significant). Performing coronary artery bypass surgery on high-risk patients did not adversely affect risk-adjusted mortality rates compared to routine patients (2.94% vs 3.02%, not statistically significant).