Low-mortality hospitals better with heart surgery complications
Haritha G. Reddy, of the University of Michigan in Ann Arbor, and colleagues analyzed data from 45,904 adults undergoing cardiac surgery at 33 medical centers in Michigan between 2006 and 2010. Rates of complications and probability of death after a complication (failure to rescue [FTR] rates) were compared across hospitals ranked by mortality rates (low, medium, and high), with a focus on 17 major postoperative complications.
The researchers found the overall unadjusted mortality rate to be 2.6 percent, ranging from 1.5 percent at low-mortality hospitals to 3.6 percent at high-mortality hospitals. The rate for the 17 complications was 19.1 percent in the low-mortality group and 22.9 percent in the high-mortality group. The overall FTR rate was significantly lower for the low-mortality hospitals (6.6 percent) than for the high-mortality hospitals (13.5 percent). For 11 of the 17 complications, including cardiac arrest, dialysis, prolonged ventilation, and pneumonia, the FTR rate was significantly lower at low-mortality hospitals compared with high-mortality hospitals.
"These data suggest that while patients at low-mortality hospitals suffer fewer complications than high-mortality hospitals, what truly distinguishes these high-performing hospitals is their superior ability to recognize and rescue patients from complications that arise after cardiac surgery procedures," the authors write.
Full Text (subscription or payment may be required)