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Int. J. Environ. Res. Public Health 2014, 11(7), 7470-7481; doi:10.3390/ijerph110707470

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

1
Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA
2
Statistical Analysis Unit, Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
3
Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
4
Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
5
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
*
Author to whom correspondence should be addressed.
Received: 10 December 2013 / Revised: 28 March 2014 / Accepted: 28 March 2014 / Published: 21 July 2014
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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. View Full-Text
Keywords: outcomes; coronary artery bypass grafting; CABG; survival; mortality outcomes; coronary artery bypass grafting; CABG; survival; mortality
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MDPI and ACS Style

Efird, J.T.; O'Neal, W.T.; Davies, S.W.; O'Neal, J.B.; Kindell, L.C.; Anderson, C.A.; Chitwood, W.R.; Ferguson, T.B.; Kypson, A.P. Risk-Adjusted Survival after Coronary Artery Bypass Grafting: Implications for Quality Improvement. Int. J. Environ. Res. Public Health 2014, 11, 7470-7481.

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