Delays for coronary artery bypass surgery: how long is too long?
When access to elective surgery is rationed by wait lists, patients requiring coronary artery bypass grafting may have to wait after a decision to operate has been made. The current literature suggests that a long wait for planned surgical revascularization may lead to worsening of symptoms, deterioration in the patient's condition and a less favorable clinical outcome; it may also increase the probability of preoperative death and unplanned emergency admission. Yet there has been little evidence generated by appropriate statistical methodology that bears on the health effects of a delay in undergoing the operation. In this article, we present three potential approaches for summarizing wait-list data. We also discuss the utility of each method for determining the point at which a delay in waiting for coronary artery bypass surgery becomes too long, from the perspectives of hospital managers, surgeons and patients.
Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Department of Health Care & Epidemiology, University of British Columbia, 828 West 10th Avenue, Vancouver, V5Z 1L8, Canada. sobolev@interchange.ubc.ca.
Boris
B
Sobolev
Guy
G
Fradet