| Autor: |
Gabriela O. Escalante, BA, Jocelyn Sun, MPH, Susan Schnell, MSN, ACNP-BC, Emily Guderian, BSN, RN, Charles A. Mack, MD, Michael Argenziano, MD, Paul Kurlansky, MD |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
JTCVS Open, Vol 16, Iss , Pp 509-521 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2666-2736 |
| DOI: |
10.1016/j.xjon.2023.10.014 |
| Popis: |
Objective: The study objective was to examine the association between hospital processes of care and failure to rescue in a diverse, multi-institutional cardiac surgery network. Methods: Failure to rescue was defined as an operative mortality after 1 or more of 4 complications: prolonged ventilation, stroke, renal failure, and unplanned reoperation. Society of Thoracic Surgeons data from 20,950 consecutive patients in the Columbia HeartSource network who underwent 1 of 7 cardiac operations—coronary artery bypass grafting, aortic valve replacement ± coronary artery bypass grafting, mitral valve repair or replacement ± coronary artery bypass grafting—were analyzed to calculate failure to rescue rates. Hospital-specific characteristics were ascertained by survey method. Multivariable mixed-effects logistic models assessed the association of these hospital characteristics with failure to rescue while adjusting for patient-related factors known to be associated with mortality. Results: Failure to rescue rates at affiliate hospitals ranged from 5.45% to 21.74% (median, 12.5%; interquartile range, 6.9%). When controlling for Society of Thoracic Surgeons–predicted risk of mortality with hospital as a random effect, 4 hospital characteristics were found to be associated with lower failure to rescue rates; the presence of cardiac-trained anesthesiologists (odds ratio, 0.41; CI, 0.31-0.55, P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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