Department of Quantitative Health Sciences
Aged; Analysis of Variance; Cohort Studies; Coronary Artery Bypass; Diagnosis-Related Groups; Female; *Hospital Mortality; Humans; Logistic Models; Male; Massachusetts; Middle Aged; Multivariate Analysis; Odds Ratio; Risk Assessment; Survival Analysis; Treatment Outcome
Biostatistics | Epidemiology | Health Services Research
Our objectives were (1) to determine if studying hospital complication rates after coronary artery bypass graft (CABG) surgery provides information not available when only mortality is studied, and (2) to reexplore the utility of ICD-9-CM administrative data for CABG outcomes assessment. Using data from Massachusetts, we identified CABG cohorts from 1990 and 1992 to respectively develop and validate multivariate risk adjustment models predicting in-hospital mortality and complications. The resulting models had good discrimination and calibration. In 1992, adjusted hospital complication rates ranged widely from 13.0% to 57.6%, while mortality rates ranged from 1.4% to 6.1%. Hospitals with high complication rates tended to have high mortality (r = 0.74, p = 0.006), but 2 of the 12 hospitals studied ranked quite differently when judged by complications rather than mortality. We conclude that (1) complications after CABG occur frequently and may provide information about hospital quality beyond that obtained from hospital mortality rates, and that (2) administrative data continue to be a promising resource for outcomes research.
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Citation: Methods Inf Med. 1998 Jun;37(2):192-200. Link to article on publisher's site
Methods of information in medicine
Ghali, William A.; Hall, Ruth E.; Ash, Arlene S.; Rosen, Amy K.; and Moskowitz, Mark A., "Evaluation of complication rates after coronary artery bypass surgery using administrative data" (1998). Quantitative Health Sciences Publications and Presentations. 675.