CABG, PCI Rates Decline in CA

Cheryl Clark, for HealthLeaders Media , June 14, 2011

Significantly, there is a huge variation in mortality by hospital after adjusting for patients' pre-operative health.

The report, which covers bypass graft procedures in 2007 and 2008 for 120 California hospitals where they are performed, is noteworthy because unlike reports in most other states, it names not just the best and worst risk-adjusted and hospitals in 30-day mortality during 2008, but gives mortality rates on other aspects of CABG operations as well. It covers procedures done on patients who were not undergoing cardiopulmonary resuscitation on their way to the operating room.

For example, the data show the best and worst hospitals for nearly 29,000 procedures during 2007-2008 in risk-adjusted incidence of stroke after CABG, a significant complication, and shows, the best and worst hospitals during 2008 in the use of the internal mammary artery during CABG procedures – which has been associated with better outcomes.

The report is the second to list data for stroke in the aftermath of a CABG procedure. The previous one covered 2007, while the current report combines data for both 2007 and 2008.

The report also lists rates of patient death for each of 279 heart surgeons by name for both years, singling out two that had the lowest death rates and eight who had the highest.

The latest release of information from the nation's largest state database on elective cardiac surgery outcomes for hospitals and the individual doctors who perform them has found a statistically significant association between hospitals that perform more than 300 CABG procedures annually and lower mortality, compared to hospitals that perform less than 200 surgeries per year.

Mortality rates for each surgeon are listed by the hospital where the surgeon performed the operation.

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