Observational studyThe Journal of thoracic and cardiovascular surgery2023
Interhospital failure to rescue after coronary artery bypass grafting.
Observational study in The Journal of thoracic and cardiovascular surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Center Volume and Failure to Rescue in Pediatric Cardiac Surgery: Is There a Relationship?The Annals of thoracic surgery · 2026Article
- Extracorporeal Life Support Organization Center of Excellence recognition is associated with improved failure to rescue after cardiac arrest.The Journal of thoracic and cardiovascular surgery · 2024Article
- Socioeconomic distress is associated with failure to rescue in cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2024Article
- The Society of Thoracic Surgeons Definition of Failure to Rescue Should Consider Including Cardiac Arrest.The Annals of thoracic surgery · 2023Article
- Interhospital variability in failure to rescue rates following aortic valve surgery.JTCVS open · 2023Article
- Article
- The Emerging Role of "Failure to Rescue" as the Primary Quality Metric for Cardiovascular Surgery and Critical Care.Journal of clinical medicine · 2023Review
- Failure to rescue: A candidate quality metric for durable left ventricular assist device implantation.The Journal of thoracic and cardiovascular surgery · 2023Article
- Implementation of a non-intensive-care unit medical emergency team improves failure to rescue rates in cardiac surgery patients.The Journal of thoracic and cardiovascular surgery · 2023Article
- Advancing Quality Metrics for Durable Left Ventricular Assist Device Implant: Analysis of the Society of Thoracic Surgeons Intermacs Database.The Annals of thoracic surgery · 2022Article
- Importance of high-performing teams in the cardiovascular intensive care unit.The Journal of thoracic and cardiovascular surgery · 2022Article
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Authors and funding
11 authors.
Funding
Abstract
objectiveWe evaluated whether interhospital variation in mortality rates for coronary artery bypass grafting was driven by complications and failure to rescue.
methodsAn observational study was conducted among 83,747 patients undergoing isolated coronary artery bypass grafting between July 2011 and June 2017 across 90 hospitals. Failure to rescue was defined as operative mortality among patients developing complications. Complications included the Society of Thoracic Surgeons 5 major complications (stroke, surgical reexploration, deep sternal wound infection, renal failure, prolonged intubation) and a broader set of 19 overall complications. After creating terciles of hospital performance (based on observed:expected mortality), each tercile was compared on the basis of crude rates of (1) major and overall complications, (2) operative mortality, and (3) failure to rescue (among major and overall complications). The correlation between hospital observed and expected (to address confounding) failure to rescue rates was assessed.
resultsMedian Society of Thoracic Surgeons predicted mortality risk was similar across hospital observed:expected mortality terciles (P = .831). Mortality rates significantly increased across terciles (low tercile: 1.4%, high tercile: 2.8%). Although small in magnitude, rates of major (low tercile: 11.1%, high tercile: 12.2%) and overall (low tercile: 36.6%, high tercile: 35.3%) complications significantly differed across terciles. Nonetheless, failure to rescue rates increased substantially across terciles among patients with major (low tercile: 9.1%, high tercile: 14.3%) and overall (low tercile: 3.3%, high tercile: 6.8%) complications. Hospital observed and expected failure to rescue rates were positively correlated among patients with major (R
conclusionsThe reported interhospital variability in successful rescue after coronary artery bypass grafting supports the importance of identifying best practices at high-performing hospitals, including early recognition and management of complications.
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