Risk-adjusted survival after coronary artery bypass grafting: implications for quality improvement

Int J Environ Res Public Health. 2014 Jul 21;11(7):7470-81. doi: 10.3390/ijerph110707470.

Abstract

Mortality represents an important outcome measure following coronary artery bypass grafting. Shorter survival times may reflect poor surgical quality and an increased number of costly postoperative complications. Quality control efforts aimed at increasing survival times may be misleading if not properly adjusted for case-mix severity. This paper demonstrates how to construct and cross-validate efficiency-outcome plots for a specified time (e.g., 6-month and 1-year survival) after coronary artery bypass grafting, accounting for baseline cardiovascular risk factors. The application of this approach to regional centers allows for the localization of risk stratification rather than applying overly broad and non-specific models to their patient populations.

MeSH terms

  • Aged
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / mortality*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality Improvement
  • Risk Factors
  • Survival Analysis