UMMS Affiliation

Department of Quantitative Health Sciences

Date

7-10-1998

Document Type

Article

Medical Subject Headings

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

Disciplines

Biostatistics | Epidemiology | Health Services Research

Abstract

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.

Rights and Permissions

Citation: Methods Inf Med. 1998 Jun;37(2):192-200. Link to article on publisher's site

Related Resources

Link to Article in PubMed

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