title: Follow-Up After Cardiac Surgery Should be Extended to at Least 120 Days When Benchmarking Cardiac Surgery Centers.
abstract: OBJECTIVE
  Short-term (30 days) mortality frequently is used as an outcome measure after cardiac surgery, although it has been proposed that the follow-up period should be extended to 120 days to allow for more accurate benchmarking. The authors aimed to evaluate whether mortality rates 120 days after surgery were comparable to general mortality and to compare causes of death between the cohort and the general population.
  
  
  METHODS
  A multicenter descriptive cohort study using prospectively entered registry data.
  
  
  METHODS
  University hospital. The cohort was obtained from the Western Denmark Heart Registry and matched to the Danish National Hospital Register as well as the Danish Register of Causes of Death. A weighted, age-matched general population consisting of all Danish patients who died within the study period was identified through the central authority on Danish statistics.
  
  
  METHODS
  A total of 11,988 patients (>15 years) who underwent cardiac-surgery at Aarhus, Aalborg and Odense University Hospitals from April 1, 2006 to December 31, 2012 were included.
  
  
  METHODS
  Coronary artery bypass grafting, valve surgery and combinations.
  
  
  RESULTS
  Mortality after cardiac surgery matches with mortality in the general population after 140 days. Mortality curves run almost parallel from this point onwards, regardless of The European system for cardiac operative risk evaluation (EuroSCORE) and intervention. The causes of death in the cohort differed statistically significantly from the background population (p<0.0001; one-sample t-test) throughout the first postoperative year. The leading cause of death in the cohort was cardiac (38%); 53% of which was categorized as heart failure. A total of 54% of these patients were assessed preoperatively as having normal or mildly impaired heart function (EuroSCORE).
  
  
  CONCLUSIONS
  This study supported an extended follow-up period after cardiac surgery when benchmarking cardiac surgery centers. Regardless of preoperative heart function, heart failure was the consistent leading cause of death.
authors.affiliation: Department of Anaesthesiology and Intensive Care; Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus N, Denmark. Electronic address: laurhans@rm.dk.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Hansen
authors.affiliation: Department of Anaesthesiology and Intensive Care.
authors.forename: Erik
authors.initials: E
authors.lastname: Sloth
authors.affiliation: Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus N, Denmark.
authors.forename: Vibeke E
authors.initials: VE
authors.lastname: Hjortdal
authors.affiliation: Department of Anaesthesiology and Intensive Care.
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Jakobsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking / Q000379:methods* / Q000639:trends; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods* / Q000401:mortality* / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: benchmarking; cardiac surgery; cause of death; database; mortality; outcomes