Risk-Adjusted Survival after Coronary Artery Bypass Grafting: Implications for Quality Improvement

Jimmy T. Efird, Wesley T. O'Neal, Stephen W. Davies, Jason B. O'Neal, Linda C. Kindell, Curtis A. Anderson, W. Randolph Chitwood, T. Bruce Ferguson and Alan P. Kypson
Additional contact information
Jimmy T. Efird: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
Wesley T. O'Neal: Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
Stephen W. Davies: Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
Jason B. O'Neal: Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
Linda C. Kindell: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
Curtis A. Anderson: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
W. Randolph Chitwood: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
T. Bruce Ferguson: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
Alan P. Kypson: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA

IJERPH, 2014, vol. 11, issue 7, 1-12

Abstract: Mortality represents an important outcome measure following coronary artery bypass grafting. Shorter survival times may reflect poor surgical quality and an increased number of costly postoperative complications. Quality control efforts aimed at increasing survival times may be misleading if not properly adjusted for case-mix severity. This paper demonstrates how to construct and cross-validate efficiency-outcome plots for a specified time (e.g., 6-month and 1-year survival) after coronary artery bypass grafting, accounting for baseline cardiovascular risk factors. The application of this approach to regional centers allows for the localization of risk stratification rather than applying overly broad and non-specific models to their patient populations.

Keywords: outcomes; coronary artery bypass grafting; CABG; survival; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2014
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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