HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Seccareccia, F. Search for Related Content PubMed PubMed Citation Articles by Seccareccia, F. Related Collections Coronary disease Myocardial infarction

Eur J Cardiothorac Surg 2006;29:56-62
© 2006 Elsevier Science NL

The Italian CABG Outcome Study: short-term outcomes in patients with coronary artery bypass graft surgery

^a National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Via Giano della Bella, 34, I-00161 Rome, Italy
^b Department of Epidemiology, ASL RME, Rome, Italy
^c Ministry of Health, Rome, Italy

Received 4 May 2005; received in revised form 28 July 2005; accepted 28 July 2005.

^_* Corresponding author. Tel.: +39 06 49904234; fax: +39 06 49904230. (Email: fulvias{at}iss.it).

Objective: During the last decade, a worldwide growing interest in evaluating performance of health services through ‘outcome studies’ took place. This study started in early 2002 and represents the first National Health System (NHS) experience to evaluate adjusted performance indicators at national level. The aim of this study was to compare 30 days mortality after coronary artery bypass graft (CABG) between cardiac surgery centres, adjusting by confounding risk factors. Methods: All patients, aged 15–99 years, undergoing a CABG intervention after 1st January 2002 in 82 participating centres were eligible for this observational longitudinal study. For each patient, data on severity and risk factors were collected (type of procedure, haemodynamic condition, co-morbidities, recent myocardial infarction and unstable angina, ventricular function, emergency condition, vital status at 30 days). Using a multiple logistic regression analysis the best predictive model was developed for risk-adjustment; a cross-validation procedure was applied; specific risk adjusted mortality rates (RAMR) were estimated. The overall study population was used as reference standard. Results: 34,310 isolated CABG were performed in 64 of the 82 participating centres. Thirty days mortality resulted 2.61%, ranging from 0.33 to 7.63%; eight centres presented a RAMR significantly lower and seven significantly higher than the reference. Conclusions: The study provides valid measures of the heterogeneity between outcomes of the Italian cardiac surgery centres, to support decision-making by NHS management and individual patients. Although not statistically significant, RAMR dropped from year 2002 to 2004 (2.8–2.4%) suggesting that this comparative outcome assessment can contribute to the improvement of performances in cardiac surgery.

Key Words: Coronary artery bypass graft • Outcome • Risk-adjustment • Mortality

This article has been cited by other articles:

				L. A. Menicanti The surgeon, the statistics and the data Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 323 - 324. [Full Text] [PDF]

				P. D'Errigo, F. Seccareccia, S. Rosato, V. Manno, G. Badoni, D. Fusco, C. A. Perucci, and the Research Group of the Italian CABG Outcome Pro Comparison between an empirically derived model and the EuroSCORE system in the evaluation of hospital performance: the example of the Italian CABG Outcome Project Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 325 - 333. [Abstract] [Full Text] [PDF]

				N. Echahidi, P. Pibarot, J.-P. Despres, J.-M. Daigle, D. Mohty, P. Voisine, R. Baillot, and P. Mathieu Metabolic Syndrome Increases Operative Mortality in Patients Undergoing Coronary Artery Bypass Grafting Surgery J. Am. Coll. Cardiol., August 28, 2007; 50(9): 843 - 851. [Abstract] [Full Text] [PDF]

				P. E. Antunes, L. Eugenio, J. Ferrao de Oliveira, and M. J. Antunes Mortality risk prediction in coronary surgery: a locally developed model outperforms external risk models Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 437 - 441. [Abstract] [Full Text] [PDF]

				G. G.L. Biondi-Zoccai, M. Fusaro, and L. Inglese Potentials and pitfalls of clinical outcome research studies in cardiac surgery. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 855 - 856. [Full Text] [PDF]

				F. Seccareccia, C. A. Perucci, D. Fusco, and P. D'Errigo Reply to biondi-zoccai et Al. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 856 - 856. [Full Text] [PDF]

				F. Seccareccia, C. A. Perucci, D. Fusco, and P. D'Errigo Reply to hekmat et Al. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 857 - 858. [Full Text] [PDF]

				K. Hekmat, U. Mehlhorn, and T. Wahlers Do we need the new Italian risk stratification model for CABG patients? Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 856 - 857. [Full Text] [PDF]

				F. Seccareccia, C. A. Perucci, P. D'Errigo, and D. Fusco Concerning the Editorial comment by Dr Menicanti. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 858 - 859. [Full Text] [PDF]