BACKGROUND: The purpose of this study was to determine whether risk-adjusted coronary artery bypass grafting mortality rates are significantly related to coronary artery bypass grafting surgical procedure volume within the Department of Veterans Affairs hospital system. METHODS: From April 1987 to September 1992, expected mortality rates were calculated for 23,986 coronary artery bypass grafting procedures performed at 44 different Veterans Affairs hospitals. RESULTS: This study found a statistically significant relationship between annual hospital coronary artery bypass grafting volume and observed mortality rates (p < 0.02). However, no statistically significant relationship between coronary artery bypass grafting volume and risk-adjusted operative mortality was found (p = 0.10). Using analysis of variance on hospital-level data, hospitals with 100 or less cases per year have higher observed to expected mortality ratios than hospitals performing more than 100 cases per year (p = 0.03). Using Poisson regression models, however, a volume threshold could not be found. CONCLUSIONS: These findings are consistent with the current Veterans Affairs policy requirements to periodically review quality at low-volume hospitals.
BACKGROUND: The purpose of this study was to determine whether risk-adjusted coronary artery bypass grafting mortality rates are significantly related to coronary artery bypass grafting surgical procedure volume within the Department of Veterans Affairs hospital system. METHODS: From April 1987 to September 1992, expected mortality rates were calculated for 23,986 coronary artery bypass grafting procedures performed at 44 different Veterans Affairs hospitals. RESULTS: This study found a statistically significant relationship between annual hospital coronary artery bypass grafting volume and observed mortality rates (p < 0.02). However, no statistically significant relationship between coronary artery bypass grafting volume and risk-adjusted operative mortality was found (p = 0.10). Using analysis of variance on hospital-level data, hospitals with 100 or less cases per year have higher observed to expected mortality ratios than hospitals performing more than 100 cases per year (p = 0.03). Using Poisson regression models, however, a volume threshold could not be found. CONCLUSIONS: These findings are consistent with the current Veterans Affairs policy requirements to periodically review quality at low-volume hospitals.
Authors: S F Khuri; J Daley; W Henderson; K Hur; M Hossain; D Soybel; K W Kizer; J B Aust; R H Bell; V Chong; J Demakis; P J Fabri; J O Gibbs; F Grover; K Hammermeister; G McDonald; E Passaro; L Phillips; F Scamman; J Spencer; J F Stremple Journal: Ann Surg Date: 1999-09 Impact factor: 12.969
Authors: F L Grover; A L Shroyer; K Hammermeister; F H Edwards; T B Ferguson; S W Dziuban; J C Cleveland; R E Clark; G McDonald Journal: Ann Surg Date: 2001-10 Impact factor: 12.969
Authors: Thomas J Papadimos; Robert H Habib; Anoar Zacharias; Thomas A Schwann; Christopher J Riordan; Samuel J Durham; Aamir Shah Journal: BMC Surg Date: 2005-05-02 Impact factor: 2.102