Heart surgery deaths often preventable
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New research indicates that roughly one third of deaths that occur in the hospital after heart bypass surgery are preventable.
The findings also suggest that while overall death rates are convenient measures of hospital quality, they do not correlate with preventable deaths.
In light of these findings, Dr. Veena Guru, from the Institute for Clinical Evaluative Sciences in Toronto, and colleagues conclude that healthcare “providers should conduct detailed adverse event audits to drive meaningful improvements in quality.”
The study involved a review of 347 randomly selected patients who died after heart surgery at nine centers in Ontario from 1998 to 2003, according to the report in the journal Circulation.
Two experienced heart surgeons reviewed medical chart summaries to determine if the deaths were preventable. A third reviewer was brought in to examine the cases when the two surgeons were in disagreement. Preventable death rates were estimated at each center and then compared with overall death rates.
Although the overall death rate across hospitals ranged from 1.3 to 3.1 percent, a total of 111 of the deaths (32 percent) were deemed preventable, the report indicates. As noted, overall death rates did not correlate with preventable deaths.
Eighty-six percent of the preventable deaths were associated with problems in the operating room and 61 percent were related to problems in the intensive care unit, the authors report. Up to 42 percent of deaths were linked to deviations from standard surgical care.
The current research “has revealed a surprisingly high rate of preventable deaths” at hospitals that appear to be doing well according to their overall death rates, Dr. Harlan M. Krumholz, from Yale-New Haven Hospital in Connecticut, comments in a related editorial.
He adds that “to reach their full potential, however, these high-achieving institutions should be able to do even better. The success of the work reported in this study will be determined by the changes that are made within the participating institutions and the results that are subsequently achieved.”
SOURCE: Circulation, June 10, 2008.
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