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Out-of-Hospital 30-day Deaths After Cardiac Surgery Are Often Underreported
Journal article   Open access   Peer reviewed

Out-of-Hospital 30-day Deaths After Cardiac Surgery Are Often Underreported

Edward L. Hannan, Zaza Samadashvili, Kimberly Cozzens, Joanna Chikwe, David H. Adams, Thoralf M. Sundt, Leonard Girardi, Craig R. Smith, Stephen J. Lahey, Jeffrey P. Gold, …
The Annals of thoracic surgery, v 110(1)
01 Jul 2020
PMID: 31715155
url
https://doi.org/10.1016/j.athoracsur.2019.09.061View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Respiratory System Science & Technology Surgery
Background. Operative mortality (in-hospital during the index admission or within 30 days of the procedure after discharge) is commonly used as a quality of care measure for public reporting of cardiac surgery outcomes, but the ability to capture out-of-hospital deaths accu- rately remains undetermined. The objective of the study was to estimate the impact of incomplete reporting of out- of-hospital deaths on hospital risk-adjusted mortality and outlier status. Methods. New York State's 2014 to 2016 cardiac regis- try data were used to compare the capture of 30-day postprocedure deaths after discharge with and without the use of national and state-level vital statistics data for all 54,442 patients undergoing isolated coronary artery bypass graft, cardiac valve surgery, or both. Hospital risk- adjusted operative mortality rates and mortality outliers were compared based on statistical models that were developed with and without the use of vital statistics data. Results. Thirty-day deaths postprocedure after discharge ranged from 10% to 39% of all operative deaths among cardiac surgical procedures. More than 30% of these deaths were missing without vital statistics con firmation for 7 of the 10 cardiac procedures exam- ined, and more than 40% were missing for 5 of the procedures examined. When vital statistics data were used to con firm 30-day postprocedure deaths after discharge, an additional high outlier for valve surgery was identi fied. Conclusions. Operative mortality after cardiac surgery is often underreported owing to a considerable percent- age of out-of-hospital cardiac surgery deaths that are missed by reporting centers. This can adversely affect the assessment of hospital risk-adjusted mortality in public reports. (Ann Thorac Surg 2020;110:183-8) (C) 2020 by The Society of Thoracic Surgeons

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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