Het volume van chirurgische ingrepen en de impact ervan op ... - KCE
Het volume van chirurgische ingrepen en de impact ervan op ... - KCE
Het volume van chirurgische ingrepen en de impact ervan op ... - KCE
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>KCE</strong> Reports 113 Volume Outcome 145<br />
Table 6.16: CABG and/or heart valve replacem<strong>en</strong>t/repair: Summary<br />
measures of <strong>volume</strong> per surgeon<br />
Type of interv<strong>en</strong>tion Number Mean Min 25th 50th 75th Max Total<br />
Pctl Pctl Pctl<br />
CABG + heart valve 87 19.0 1 6.0 12.0 26.0 125 1655<br />
Isolated CABG 100 68.1 1 25.0 56.5 100.5 291 6806<br />
Isolated heart valve 92 20.2 1 6.0 14.0 25.0 122 1860<br />
TOTAL VOLUME 104 99.2 1.0 40.0 92.0 157.0 318 10321<br />
6.2.5 Definition of outcomes<br />
Overall, in-hospital mortality was 4.71%, and <strong>de</strong>p<strong>en</strong>ds both on the type of <strong>op</strong>eration and<br />
on the principal diagnosis (see Table 6.17). In-hospital mortality combined with<br />
approximate 30-day mortality was 5.15%. The total number of stays (Number Total) is<br />
slightly lower because not all stays could be linked to IMA data.<br />
Table 6.17: CABG and/or heart valve replacem<strong>en</strong>t/repair: In-hospital<br />
mortality, by type of procedure and principal diagnosis<br />
Number<br />
Total<br />
number<br />
Death % Death<br />
In-hospital mortality 10647 501 4.71<br />
In-hospital mortality and approximate 30-day mortality 10372 534 5.15<br />
In-hospital mortality by type of procedure<br />
Isolated CABG 7043 249 3.54<br />
Isolated heart valve 1949 109 5.59<br />
CABG + heart valve 1655 143 8.64<br />
In-hospital mortality by Principal Diagnosis<br />
396 Diseases of mitral and aortic valves 432 25 5.79<br />
410 Acute myocardial infarction 548 70 12.77<br />
414 Other forms of chronic ischemic heart disease 6641 211 3.18<br />
424 Other diseases of <strong>en</strong>docardium 2215 110 4.97<br />
428 Heart failure 138 17 12.32<br />
441 Aortic aneurysm and dissection 105 13 12.38<br />
996 Complications peculiar to certain specified procedures 180 17 9.44<br />
Other 388 38 9.79<br />
6.2.6 Volume outcome relationship<br />
6.2.6.1 Analysis by hospital<br />
IN-HOSPITAL MORTALITY RATE, BY HOSPITAL<br />
Figure 6.10 pres<strong>en</strong>ts the observed association betwe<strong>en</strong> the number of procedures and<br />
in-hospital mortality. The horizontal line repres<strong>en</strong>ts the overall in-hospital mortality i.e.<br />
4.7%. The funnel plot shows that there are a few low <strong>volume</strong> c<strong>en</strong>tres above the<br />
expected upper limit of variability, and also that the two highest <strong>volume</strong> c<strong>en</strong>tres are at<br />
the lower limit of the expected variability. Data for isolated CABG are pres<strong>en</strong>ted in<br />
Figure 6.11.
Change language