The Journal of Thoracic and Cardiovascular Surgery
Adult: Perioperative ManagementNational trend in failure to rescue after cardiac surgeries
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Data Source and Patient Population
The data for this study were extracted from the National Inpatient Sample (NIS) data set, which is a part of the Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality (AHRQ). The NIS is the largest publicly available all-payer inpatient health care database in the United States. It contains data on approximately 8 million discharges each year. The sampling frame of NIS was changed in 2012. Before 2012 data were collected from more than 1000
Results
A total of 6,185,032 major cardiac surgeries were performed from 2000 through 2018. At least 1 serious treatable complication occurred after 274,791 surgeries (4.4%). In-hospital deaths due to postoperative complications were 33,170 (0.5% of total or 12.1% of surgeries with complications).
Discussion
Our study describes the FTR rate after cardiac surgeries on the national level and draws the pattern of how the FTR rate changed over the years using the NIS all-payer database. Administrative discharge databases are considered appropriate for assessing the quality or outcomes of care and examining the assessment of the effect of new health care policies, guidelines, or practices on the FTR rate.21 Thus, these databases are usually used to rank hospitals according to specialties.
We observed a
Conclusions
During the past 19 years, the risk of death after complications for older patients became comparable with mortality for younger patients. Despite progress in the treatment of complications and reduction of mortality after sepsis and DVT or PE, FTR rates are increasing in recent years, mainly because of the increase in failure rates after pneumonia and GI bleeding. Further studies are needed to determine the cause of these increased rates and to deliver targeted policy and practice changes to
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