Evaluation of Complication Rates after Coronary Artery Bypass Surgery using Administrative Data

W. A. Ghali; R. E. Hall; A. S. Ash; A. K. Rosen; M. A. Moskowitz

doi:10.1055/s-0038-1634511

Methods of Information in Medicine, Table of Contents

Methods Inf Med 1998; 37(02): 192-200
DOI: 10.1055/s-0038-1634511

Original Article

Schattauer GmbH

Evaluation of Complication Rates after Coronary Artery Bypass Surgery using Administrative Data

W. A. Ghali¹

¹Health Care Research Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center, Boston, MA,USA

,

R. E. Hall¹

¹Health Care Research Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center, Boston, MA,USA

,

A. S. Ash

¹Health Care Research Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center, Boston, MA,USA

,

A. K. Rosen¹

¹Health Care Research Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center, Boston, MA,USA

,

M. A. Moskowitz

¹Health Care Research Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center, Boston, MA,USA

› Author Affiliations

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.

Keywords

Coronary Bypass - Complications - Mortality - ICD-9-CM - Risk Adjustment

Full Text

References

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