title: In-hospital mortality rates after CABG by autonomous regions in Spain.
abstract: OBJECTIVE
  The paper's purpose is twofold: to provide a predictive model for estimating in-hospital mortality rates after coronary artery bypass grafting (CABG) in Spanish autonomous regions (AR) after adjusting relevant factors; and to determine whether there is a difference between expected and observed mortality rates.
  
  
  METHODS
  All patients registered in a minimum basic data set (MSBD) undergoing CABG between 2000 and 2004 were selected. After bivariate analysis to explore associations between in-hospital death and other variables, a multivariate analysis using logistic regression was conducted. The predictive model was evaluated using calibration and discrimination techniques. Standardized mortality ratios by AR were calculated.
  
  
  RESULTS
  The expected Spanish in-hospital mortality rate after CABG was 7.68 and the observed rate was 7.69 deaths per 100 operations. Discrimination obtained with the model resulted in an area under the curve of 0.70 (95 per cent CI, 0.69-0.71). When each AR's mortality rate is calculated and compared with the observed rate, some ARs present an observed mortality rate higher or lower than the expected rate according to adjusted variables in the model.
  
  
  CONCLUSIONS
  The MSBD registry does not contain patients' critical data, such as arterial damage severity, or in which hospital procedures were performed.
  
  
  CONCLUSIONS
  There are factors related to individual patient variation, financial resources or healthcare quality in different ARs, which should be investigated in follow-up studies.
  
  
  CONCLUSIONS
  The paper shows that, although the global expected mortality rate is almost the same as the observed Spanish mortality rate, this similarity disappears when AR rates are compared.
authors.affiliation: Hospital General Universitario Gregorio Marañón, Servicio de Medicina Preventiva y Gestión de Calidad, Madrid, Spain. rodriguezrieiro@gmail.com
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodríguez-Rieiro
authors.forename: Paz
authors.initials: P
authors.lastname: Rodríguez Pérez
authors.forename: Susana
authors.initials: S
authors.lastname: Granado de la Orden
authors.forename: Mercedes
authors.initials: M
authors.lastname: Moreno Moreno
authors.forename: Ana Chacón
authors.initials: AC
authors.lastname: García
authors.forename: Amaya
authors.initials: A
authors.lastname: Sánchez-Gómez
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology