title: Risk-adjusted survival after coronary artery bypass grafting: implications for quality improvement.
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.
authors: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. jimmy.efird@stanfordalumni.org.
authors: Jimmy T
authors: JT
authors: Efird
authors: Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. woneal@wakehealth.edu.
authors: Wesley T
authors: WT
authors: O'Neal
authors: Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. sd2wf@virginia.edu.
authors: Stephen W
authors: SW
authors: Davies
authors: Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. jboneal@bidmc.harvard.edu.
authors: Jason B
authors: JB
authors: O'Neal
authors: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. kindelll@ecu.edu.
authors: Linda C
authors: LC
authors: Kindell
authors: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. andersoncu@ecu.edu.
authors: Curtis A
authors: CA
authors: Anderson
authors: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. chitwoodw@ecu.edu.
authors: W Randolph
authors: WR
authors: Chitwood
authors: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. fergusont@ecu.edu.
authors: T Bruce
authors: TB
authors: Ferguson
authors: Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, East Carolina University, Greenville, NC 27834, USA. kypsona@ecu.edu.
authors: Alan P
authors: AP
authors: Kypson
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D012307:Risk Factors; D016019:Survival Analysis