Document Detail


No continuous relationship between Veterans Affairs hospital coronary artery bypass grafting surgical volume and operative mortality.
MedLine Citation:
PMID:  8561546     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine whether risk-adjusted coronary artery bypass grafting mortality rates are significantly related to coronary artery bypass grafting surgical procedure volume within the Department of Veterans Affairs hospital system. METHODS: From April 1987 to September 1992, expected mortality rates were calculated for 23,986 coronary artery bypass grafting procedures performed at 44 different Veterans Affairs hospitals. RESULTS: This study found a statistically significant relationship between annual hospital coronary artery bypass grafting volume and observed mortality rates (p < 0.02). However, no statistically significant relationship between coronary artery bypass grafting volume and risk-adjusted operative mortality was found (p = 0.10). Using analysis of variance on hospital-level data, hospitals with 100 or less cases per year have higher observed to expected mortality ratios than hospitals performing more than 100 cases per year (p = 0.03). Using Poisson regression models, however, a volume threshold could not be found. CONCLUSIONS: These findings are consistent with the current Veterans Affairs policy requirements to periodically review quality at low-volume hospitals.
Authors:
A L Shroyer; G Marshall; B A Warner; R R Johnson; W Guo; F L Grover; K E Hammermeister
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  61     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-02-23     Completed Date:  1996-02-23     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  17-20     Citation Subset:  AIM; IM    
Affiliation:
Denver Veterans Affairs Medical Center, Division of Cardiothoracic Surgery, CO 80220, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Coronary Artery Bypass / mortality*,  statistics & numerical data
Hospital Mortality
Hospitals, Veterans / statistics & numerical data*
Humans
Poisson Distribution
Risk Factors
Comments/Corrections
Comment In:
Ann Thorac Surg. 1996 Sep;62(3):941-3   [PMID:  8784048 ]

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


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