Coronary artery bypass mortality rates in Ontario. A Canadian approach to quality assurance in cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario.
Coronary artery bypass mortality rates in Ontario. A Canadian approach to quality assurance in cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario.
复制标题
安大略省冠状动脉搭桥死亡率。
DOI：
10.1161/01.cir.94.10.2429
复制
发表时间：
1996
期刊：
影响因子：
37.8
通讯作者：
Naylor,CD
中科院分区：
文献类型：
--
作者：
Tu,JV;Naylor,CD
背景：本研究旨在评估加拿大安大略冠状动脉旁路移植术（CABG）后的总体死亡率和风险调整后死亡率的医院间差异。CABG的结果数据没有公开传播在安大略.Methods和ResultsClinical危险因素和手术结果收集了15 608例患者进行隔离CABG手术之间，1991年4月1日，1994年3月31日，在九家医院进行成人心脏手术在安大略。这些数据是根据财政年度进行分析的。总死亡率为3.01%，风险调整死亡率从1991年的3.17%下降到1993年的2.93%。1991年，九家医院中有一家的风险调整死亡率明显低于全省平均水平。除此之外，在研究期间，所有医院的风险调整死亡率均在预期范围内。所有医院在1992年和1993年进行了>300例CABG手术，而在1993年，42名心脏外科医生中只有2名进行了<50例CABG手术。结论安大略CABG手术后的院内死亡率较低，风险调整后死亡率的医院间变化量并不大于预期的偶然性。这些结果可能归因于CABG手术的区域化和安大略低容量心脏外科医生的非常低的患病率。
BackgroundThis study was conducted to assess the overall mortality rate and the amount of interhospital variation in risk-adjusted mortality rates after coronary artery bypass graft (CABG) surgery in Ontario, Canada. CABG outcomes data are not publicly disseminated in Ontario.Methods and ResultsClinical risk factors and surgical outcomes were collected on 15 608 patients undergoing isolated CABG surgery between April 1, 1991, and March 31, 1994, at the nine hospitals performing adult cardiac surgery in Ontario. The data were analyzed on the basis of a fiscal year. The overall mortality rate was 3.01%, and the risk-adjusted mortality rate declined from 3.17% in 1991 to 2.93% in 1993. In 1991, one of the nine hospitals had a risk-adjusted mortality rate significantly lower than the provincial average. Otherwise, the hospitals all had risk-adjusted mortality rates within the expected range during the time period of the study. All hospitals performed >300 CABG procedures in 1992 and 1993, and only 2 of 42 cardiac surgeons performed <50 CABG procedures in 1993.ConclusionsThe in-hospital mortality rate after CABG surgery in Ontario is low, and the amount of interhospital variation in risk-adjusted mortality rates is no greater than that expected by chance alone. These outcomes are probably attributable to regionalization of CABG surgery and a very low prevalence of low-volume cardiac surgeons in Ontario.