skip to main content
Language:
Search Limited to: Search Limited to: Resource type Show Results with: Show Results with: Index

Hospital Coronary Artery Bypass Graft Surgery Volume and Patient Mortality, 1998–2000

Rathore, S., Saif ; Epstein, J., Andrew ; Volpp, G. M., Kevin ; Krumholz, M., Harlan

Annals of Surgery, 2004, Vol.239(1), pp.110-117 [Peer Reviewed Journal]

Full text available

Citations Cited by
  • Title:
    Hospital Coronary Artery Bypass Graft Surgery Volume and Patient Mortality, 1998–2000
  • Author: Rathore, S., Saif ; Epstein, J., Andrew ; Volpp, G. M., Kevin ; Krumholz, M., Harlan
  • Description: OBJECTIVE:: To evaluate the association between annual hospital coronary artery bypass graft (CABG) surgery volume and in-hospital mortality. SUMMARY BACKGROUND DATA:: The Leapfrog Group recommends health care purchasers contract for CABG services only with hospitals that perform ≥500 CABGs annually to reduce mortality; it is unclear whether this standard applies to current practice. METHODS:: We conducted a retrospective analysis of the National Inpatient Sample database for patients who underwent CABG in 1998–2000 (n = 228,738) at low (12–249 cases/year), medium (250–499 cases/year), and high (≥500 cases/year) CABG volume hospitals. Crude in-hospital mortality rates were 4.21% in low-volume hospitals, 3.74% in medium-volume hospitals, and 3.54% in high-volume hospitals (trend P < 0.001). Compared with patients at high-volume hospitals (odds ratio 1.00, referent), patients at low-volume hospitals remained at increased risk of mortality after multivariable adjustment (odds ratio 1.26, 95% confidence interval = 1.15–1.39). The mortality risk for patients at medium-volume hospitals was of borderline significance (odds ratio 1.11, 95% confidence interval = 1.01–1.21). However, 207 of 243 (85%) of low-volume and 151 of 169 (89%) of medium-volume hospital-years had risk-standardized mortality rates that were statistically lower or comparable to those expected. In contrast, only 11 of 169 (6%) of high-volume hospital-years had outcomes that were statistically better than expected. CONCLUSIONS:: Patients at high-volume CABG hospitals were, on average, at a lower mortality risk than patients at lower-volume hospitals. However, the small size of the volume-associated mortality difference and the heterogeneity in outcomes within all CABG volume groups suggest individual hospital CABG volume is not a reliable marker of hospital CABG quality.
  • Is Part Of: Annals of Surgery, 2004, Vol.239(1), pp.110-117
  • Identifier: ISSN: 0003-4932 ; DOI: 10.1097/01.sla.0000103066.22732.b8
  • Source: Copyright © 2013 Lippincott Williams & Wilkins. All rights reserved.

Searching Remote Databases, Please Wait