Document Detail

Death in low-risk cardiac surgery: the failure to achieve a satisfactory cardiac outcome (FIASCO) study.
MedLine Citation:
PMID:  19602493     Owner:  NLM     Status:  MEDLINE    
Death in low-risk patients is not studied as frequently as it is in other cardiac patients. We, therefore, sought to determine why some low-risk patients die after cardiac surgery. All low-risk patients (EuroSCORE<or=2) who died after cardiac surgery in one institution between 1996 and 2005 were included and meticulously studied by internal and independent external review of preoperative, operative and postoperative information from the case-notes and post-mortem findings. Deaths were classified into non-cardiac and cardiac and further subclassified into unavoidable deaths or due to failure in achieving a satisfactory cardiac outcome (FIASCO). Between 1996 and 2005, there were 16 deaths in 4294 low-risk patients (mortality 0.37%). Internal and external review agreed that nine deaths were non-preventable (CVA, bronchopneumonia, etc.) and that avoidable FIASCO accounted for seven deaths. Of the deaths considered to be preventable, all had probable errors of technique and three also had additional system errors. No cardiac operation is without risk. Mortality, though fortunately rare, can still occur, even in low-risk patients. Despite an extremely low mortality in the low-risk group FIASCO still accounts for nearly one-half of deaths. This suggests that mortality may be reduced even further as part of a quality improvement programme.
Darren H Freed; Andrew J Drain; Jago Kitcat; Mark T Jones; Samer A M Nashef
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Publication Detail:
Type:  Journal Article     Date:  2009-07-14
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-23     Completed Date:  2009-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  623-5     Citation Subset:  IM    
Cardiothoracic Surgical Unit, Papworth Hospital, Cambridge CB3 8RE, UK.
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MeSH Terms
Cardiac Surgical Procedures / mortality*
Cause of Death
Health Status Indicators*
Logistic Models
Medical Errors / prevention & control*
Outcome and Process Assessment (Health Care) / statistics & numerical data*
Predictive Value of Tests
Quality Indicators, Health Care / statistics & numerical data*
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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