Cardiac Surgery Death Rate Remains Low

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STATE—New Jersey’s mortality rate following cardiac surgery remains at its lowest level since the state began collecting data, according to the report Cardiac Surgery in New Jersey 2007 released today by the Department of Health and Senior Services.

The state’s 11th report on coronary artery bypass graft (CABG) surgery examines death rates within 30 days of surgery, infection rates and hospital length-of-stay.  In 2007, the overall mortality rate remained at 2 percent—the same rate as in 2006.  This represents a 54 percent decline since the first report covering the years 1994-1995.

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According to the 2007 report, the number of CABG surgeries in New Jersey continued to decline with the increasing use of angioplasty.  There were 4,943 bypass surgeries performed in 2007 in 18 hospitals.  Ninety-nine patients died in the hospital or within 30 days of surgery.

Fifteen of the 18 cardiac surgery hospitals had risk-adjusted cardiac surgery death rates in line with the statewide average.  Three of the 18 hospitals had a rate that was statistically significantly higher than the statewide average.

No hospital had a significantly lower-than-average rate.  It would take a high volume of cases and a very low mortality rate for any one hospital to outperform the rest with a statistically significantly lower-than-average rate.

The department risk-adjusts all hospital and surgeon rates to, in effect, give “extra credit” to those treating sicker patients.  Rates are reported for individual surgeons who have performed at least 100 bypass procedures in one hospital in 2006 and 2007 combined.

As an additional tool for monitoring quality care, the Department requires hospitals to report on infections among patients undergoing CABG.

According to the report, 391 patients, or nearly 8 percent of cases, developed an infection.  Pneumonia, urinary tract infections and blood stream infections were the three most common, and blood stream infections were the most deadly.

Infected patients had longer hospital stays – 18.2 days compared with 6.66 for patients without infections.  Patients with infections also had a much higher death rate — 11.5 percent—while the rate for uninfected patients was 1.2.

“New Jersey’s hospitals and physicians have worked hard to improve the quality of cardiac surgical care, and that has meant better health for patients and hundreds of lives saved,” said Health and Senior Services Commissioner Dr. Poonam Alaigh.  “We must continue striving to make cardiac surgery as safe as possible, for example by working to reduce the occurrence of potentially deadly infections among surgical patients.”

In January 2009, hospitals statewide began reporting additional data on health care-associated infections under a state law that mandates reporting.  In the fall, the Department will begin publishing data in its annual Hospital Performance Report.  DHSS is collecting data on all health care-associated bloodstream infections, and infections related to CABG surgery and abdominal hysterectomy.

In producing the cardiac surgery report, the Department is advised by the Commissioner’s Cardiovascular Health Advisory Panel (CHAP), a group that includes cardiologists, surgeons, nurses and others.

“With the panel’s expert advice, the Department is able to publish reliable, high-quality data that is useful both to consumers and the provider community,” said Alaigh.  “I thank the panel for their work and for their commitment to improving health care.”

New Jersey is one of five states to report on cardiac surgery outcomes.  California, Massachusetts, New York and Pennsylvania issue similar reports.

The report is available on the DHSS web site at www.nj.gov/health.  Reports are also available by emailing hcqa@doh.state.nj.us or by writing to the New Jersey Department of Health and Senior Services, Office of Health Care Quality Assessment, P.O. Box 360, Trenton, NJ 08625-0360.


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