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Low-mortality hospitals best equipped to handle cardiac surgery complications
Hospitals with low rates of patient mortality have superior ability to rescue patients from complications after cardiac surgery vs. medium- and high-mortality hospitals.
Researchers analyzed failure to rescue data for 45,904 adults who underwent cardiac surgery at one of 33 surgical programs in Michigan from 2006 to 2010.
The study was designed to examine whether variations in surgical mortality were related to differences in the incidence of complications or differences in the success of managing complications once they occur. The 33 centers were rated according to the observed-to-expected mortality rate and then categorized as a low-mortality, medium-mortality or high-mortality center. Researchers then compared rates of complications and failure to rescue, according to a press release.
Results showed an unadjusted mortality rate of 2.6%, ranging from 1.5% at low-mortality hospitals to 3.6% at high-mortality hospitals.
Complication rates varied among the groups; however, differences were not significant. The rate of 17 complications ranged from 19.1% at the low-mortality hospitals to 22.9% at high-mortality hospitals.
The failure to rescue rate was markedly elevated in hospitals with higher overall mortality. Patients treated at high-mortality hospitals were more than two times as likely to die after developing a complication compared with patients treated at low-mortality hospitals (6.6% for low-mortality group, 10.4% for medium-mortality group, 13.5% for high-mortality group), according to the release.
“This study shows that reviewing patients’ surgical outcomes using a collaborative multi-hospital approach can provide an ideal opportunity to review processes that anticipate and manage complications in the intensive care unit and help institutions recognize and share ‘differentiators’ in care,” Richard L. Prager, MD, professor of cardiac surgery at University of Michigan Health System, said in the press release.