Abstract 17587: Coronary Artery Bypass Graft: Heart Surgery Center Performance in Contemporary China
Background: Little is known about the variation in performance of CABG in China. Our objective was to characterize the variation in performance by site across hospitals participating in a regional registry.
Methods: The study sample was drawn from the Chinese Cardiac Surgery Registry (CCSR), a national multi-center database that includes 43 hospitals across 31 provinces around China. We assessed the period January 2007 through December 2008. Consecutive patients were enrolled in the registry and 284 data elements were collected. Hierarchical generalized linear models were developed to produce the risk-standardized in-hospital mortality rate (RSMR) and risk-standardized major complication rate (RSCR) for patients who undergoing CABG. The models adjusted for demographic and clinical factors. The same models also were used to estimate the between-hospital variances on RSMR and RSCR.
Results: A total of 9844 consecutive CABG patients were included. Mean (standard deviation) age was 62.1 (9.2) years and 77.2% were male. Observed in-hospital mortality and complication were 2.7% and 6.8%, respectively. The RSMRs ranged from 1.2% to 7.7%, and the RSCRs ranged from 3.4% to 10.7%. The odds of dying and of a complication when undergoing surgery at a hospital one standard deviation (SD) below quality relative to a hospital one SD above quality were 2.48 and 1.47 respectively.
Conclusions: There is much variation in the results achieved by Chinese sites participating in a regional registry. These results suggest that there is ample opportunity for improvements in performance.
- © 2010 by American Heart Association, Inc.