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

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  • Jimmy T. Efird

    (Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
    Statistical Analysis Unit, Center for Health Disparities, Brody School of Medicine, 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)

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.

Suggested Citation

  • 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 & Alan P. Kypson, 2014. "Risk-Adjusted Survival after Coronary Artery Bypass Grafting: Implications for Quality Improvement," IJERPH, MDPI, vol. 11(7), pages 1-12, July.
    • Handle: RePEc:gam:jijerp:v:11:y:2014:i:7:p:7470-7481:d:38357
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    References listed on IDEAS

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    1. Jimmy T. Efird & Wesley T. O'Neal & Paul Bolin & Stephen W. Davies & Jason B. O'Neal & Curtis A. Anderson & T. Bruce Ferguson & W. Randolph Chitwood & Alan P. Kypson, 2013. "Racial Differences in Survival among Hemodialysis Patients after Coronary Artery Bypass Grafting," IJERPH, MDPI, vol. 10(9), pages 1-11, September.
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    Cited by:

    1. Stana Pačarić & Tajana Turk & Ivan Erić & Želimir Orkić & Anamarija Petek Erić & Andrea Milostić-Srb & Nikolina Farčić & Ivana Barać & Ana Nemčić, 2020. "Assessment of the Quality of Life in Patients before and after Coronary Artery Bypass Grafting (CABG): A Prospective Study," IJERPH, MDPI, vol. 17(4), pages 1-13, February.

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