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The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models.

Publication ,  Journal Article
Shroyer, ALW; Coombs, LP; Peterson, ED; Eiken, MC; DeLong, ER; Chen, A; Ferguson, TB; Grover, FL; Edwards, FH; Society of Thoracic Surgeons,
Published in: Ann Thorac Surg
June 2003

BACKGROUND: Although 30 day risk-adjusted operative mortality (ROM) has been used for quality assessment, it is not sufficient to describe the outcomes after coronary artery bypass grafting (CABG) surgery. Risk-adjusted major morbidity may differentially impact quality of care (as complications occur more frequently than death) and enhance a surgical team's ability to assess their quality. This study identified the preoperative risk factors associated with several complications and a composite outcome (the presence of any major morbidity or 30-day operative mortality or both). METHODS: For CABG procedures, the 1997 to 1999 Society of Thoracic Surgeons (STS) National Adult Cardiac Surgery Database was used to develop ROM and risk-adjusted morbidity (ROMB) models. Risk factors were selected using standard STS univariate screening and multivariate logistic regression approaches. Risk model performance was assessed. Across STS participating sites, the association of observed-to-expected (O/E) ratios for ROM and ROMB was evaluated. RESULTS: The 30-day operative death and major complication rates for STS CABG procedures were 3.05% and 13.40%, respectively (503,478 CABG procedures), including stroke (1.63%), renal failure (3.53%), reoperation (5.17%), prolonged ventilation (5.96%), and sternal infection (0.63%). Risk models were developed (c-indexes for stroke [0.72], renal failure [0.76], reoperation [0.64], prolonged ventilation [0.75], sternal infection [0.66], and the composite endpoint [0.71]). Only a slight correlation was found, however, between ROMB and ROM indicators. CONCLUSIONS: Used in combination, ROMB and ROM may provide the surgical team with additional information to evaluate the quality of their care as well as valuable insights to allow them to focus on areas for improvement.

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Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

June 2003

Volume

75

Issue

6

Start / End Page

1856 / 1864

Location

Netherlands

Related Subject Headings

  • United States
  • Survival Analysis
  • Risk Factors
  • Respiratory System
  • Quality of Health Care
  • Postoperative Complications
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
 

Citation

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ICMJE
MLA
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Shroyer, A. L. W., Coombs, L. P., Peterson, E. D., Eiken, M. C., DeLong, E. R., Chen, A., … Society of Thoracic Surgeons, . (2003). The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models. Ann Thorac Surg, 75(6), 1856–1864. https://doi.org/10.1016/s0003-4975(03)00179-6
Shroyer, A Laurie W., Laura P. Coombs, Eric D. Peterson, Mary C. Eiken, Elizabeth R. DeLong, Anita Chen, T Bruce Ferguson, Frederick L. Grover, Fred H. Edwards, and Fred H. Society of Thoracic Surgeons. “The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models.Ann Thorac Surg 75, no. 6 (June 2003): 1856–64. https://doi.org/10.1016/s0003-4975(03)00179-6.
Shroyer ALW, Coombs LP, Peterson ED, Eiken MC, DeLong ER, Chen A, et al. The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models. Ann Thorac Surg. 2003 Jun;75(6):1856–64.
Shroyer, A. Laurie W., et al. “The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models.Ann Thorac Surg, vol. 75, no. 6, June 2003, pp. 1856–64. Pubmed, doi:10.1016/s0003-4975(03)00179-6.
Shroyer ALW, Coombs LP, Peterson ED, Eiken MC, DeLong ER, Chen A, Ferguson TB, Grover FL, Edwards FH, Society of Thoracic Surgeons. The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models. Ann Thorac Surg. 2003 Jun;75(6):1856–1864.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

June 2003

Volume

75

Issue

6

Start / End Page

1856 / 1864

Location

Netherlands

Related Subject Headings

  • United States
  • Survival Analysis
  • Risk Factors
  • Respiratory System
  • Quality of Health Care
  • Postoperative Complications
  • Middle Aged
  • Male
  • Logistic Models
  • Humans