In‐hospital mortality rates after CABG by autonomous regions in Spain

Cristina Rodríguez‐Rieiro (Hospital General Universitario Gregorio Marañón Servicio de Medicina Preventiva y Gestión de Calidad, Madrid, Spain)
Paz Rodríguez Pérez (Hospital General Universitario Gregorio Marañón Servicio de Medicina Preventiva y Gestión de Calidad, Madrid, Spain)
Susana Granado de la Orden (Hospital General Universitario Gregorio Marañón Servicio de Medicina Preventiva y Gestión de Calidad, Madrid, Spain)
Mercedes Moreno Moreno (Hospital General Militar Gómez Ulla Glorieta del Ejército, Madrid, Spain)
Ana Chacón García (Hospital General Universitario Gregorio Marañón Servicio de Medicina Preventiva y Gestión de Calidad, Madrid, Spain)
Amaya Sánchez‐Gómez (Hospital General Universitario Gregorio Marañón Servicio de Medicina Preventiva y Gestión de Calidad, Madrid, Spain)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Publication date: 3 May 2011

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

The MSBD registry does not contain patients' critical data, such as arterial damage severity, or in which hospital procedures were performed.

Practical implications

There are factors related to individual patient variation, financial resources or healthcare quality in different ARs, which should be investigated in follow‐up studies.

Originality/value

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.

Keywords

Citation

Rodríguez‐Rieiro, C., Rodríguez Pérez, P., Granado de la Orden, S., Moreno Moreno, M., Chacón García, A. and Sánchez‐Gómez, A. (2011), "In‐hospital mortality rates after CABG by autonomous regions in Spain", International Journal of Health Care Quality Assurance, Vol. 24 No. 4, pp. 300-307. https://doi.org/10.1108/09526861111125606

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Publisher

:

Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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