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Eur Heart J Qual Care Clin Outcomes. 2017 Oct 1;3(4):312-318. doi: 10.1093/ehjqcco/qcx021.

Trends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013.

Yuan X1,2, Zhang H1,2, Zheng Z1,2, Rao C1,2, Zhao Y1, Wang Y3,4, Krumholz HM4,5,6, Hu S1,2.

Author information

1
National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, 167, Beilishi Road, Xicheng District, Beijing 100037, People's Republic of China.
2
Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, #167, Beilishi Road, Xicheng District, Beijing 100037, People's Republic of China.
3
Department of Biostatistics, Harvard T.H. Chan School of Public Health 655, Huntington Avenue, Boston, Massachusetts, 02115, USA.
4
The center for Outcomes Research and Evaluation and Yale-New Haven Health, 1 Church Street, Suit 200, New Haven, Cnnecticut 06510, USA.
5
Section of Cardiovascular Medicine Yale University School of Medicine, 330 Cedar Street, New Haven, Connecticut 06519, USA.
6
Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, Connecticut 06510, USA.

Abstract

Aims:

Although the number of hospitals performing cardiac surgery has increased rapidly in China, information regarding the trends in coronary artery bypass grafting (CABG) outcomes remains unknown.

Methods and results:

We used data from the Chinese Cardiac Surgery Registry, the largest registry system that accounts for nearly 50% of total annual CABG volume in China, to assess trends of in-hospital mortality and major complication rates for patients receiving isolated CABG in 102 urban teaching hospitals in China from 25 January 2004 through 31 December 2013 (except 2006 and 2009). Using a mixed effects model, we estimated annual trends in each of these two outcomes overall and by age groups (18-64 and 65 years or older), adjusted for patient characteristics. We also assessed the trends in pre-operative, post-operative, and total length of stay (LOS). The study included 40 652 patients across 102 hospitals. Between 2004 and 2013, patients' mean age decreased from 62.7 to 61.4 years, in-hospital mortality decreased from 2.8% to 1.6% (difference, 1.3%, 95% CI: 0.70-1.85), and major complication rates decreased from 7.8% to 3.8% (difference, 4.0%; 95% CI: 3.05-4.90). The reduction in mortality and major complication rates were consistent across age groups. Between 2004 and 2013, the median (inter-quartile range) pre-operative LOS remained unchanged, post-operative LOS declined from 12.0 (8.0) to 10.0 (7.0) days, and total LOS declined from 22.0 (13.0) to 20.0 (12.0) days.

Conclusion:

Isolated CABG-related in-hospital mortality, major complication rates, and LOS have improved in urban teaching hospitals in China over the last decade.

KEYWORDS:

Coronary artery bypass graft; Quality and outcomes of care

PMID:
29044398
PMCID:
PMC5805118
DOI:
10.1093/ehjqcco/qcx021
[Indexed for MEDLINE]
Free PMC Article

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