Journal article
Out-of-Hospital 30-day Deaths After Cardiac Surgery Are Often Underreported
The Annals of thoracic surgery, v 110(1)
01 Jul 2020
PMID: 31715155
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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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Details
- Title
- Out-of-Hospital 30-day Deaths After Cardiac Surgery Are Often Underreported
- Creators
- Edward L. Hannan - Cardiac Services Program, School of Public Health, University at Albany, State University of New York, Albany, New York.Zaza Samadashvili - Cardiac Services Program, School of Public Health, University at Albany, State University of New York, Albany, New York.Kimberly Cozzens - Cardiac Services Program, School of Public Health, University at Albany, State University of New York, Albany, New York.Joanna Chikwe - Stony Brook SchoolDavid H. Adams - Mount Sinai HospitalThoralf M. Sundt - Massachusetts General HospitalLeonard Girardi - Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York, New York.Craig R. Smith - NewYork–Presbyterian HospitalStephen J. Lahey - University of ConnecticutJeffrey P. Gold - University of Nebraska Medical CenterAndrew Wechsler - Drexel UniversityDesmond Jordan - NewYork–Presbyterian HospitalMohammed H. Ashraf - Kaleida HealthPaul A. Kurlansky - NewYork–Presbyterian Hospital
- Publication Details
- The Annals of thoracic surgery, v 110(1)
- Publisher
- Elsevier
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000547527300025
- Scopus ID
- 2-s2.0-85086473146
- Other Identifier
- 991019168287104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery