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Eur J Cardiothorac Surg 2006;29:62-63
© 2006 Elsevier Science NL

Editorial comment

The Italian Job on CABG outcomes

Papworth Hospital, Cardiac Surgery, Cambridge, CB3 8RE, UK

^_* Tel.: +44 1480 364299; fax: +44 1480 364744. (Email: sam.nashef@papworth.nhs.uk).

The first 20% of the full text of this article appears below.

In the Italian CABG Outcome Study, Seccareccia and colleagues reported the immediate (30-day) mortality figures for coronary surgery in 64 Italian centres. The study covers more than 34,000 patients and relates the outcome to a national risk model developed using logistic regression. Outcomes are corrected for risk according to the national model and the findings are reported with anonymity for the participating centres. Outcomes are not given for individual surgeons.

The study, as reported, has some weaknesses. We may wonder about the criteria used for data validation (we are informed that data validation was carried out, but not about any preset criteria for good data or whether the participating units satisfied these criteria). We may question the need for a new 22-factor risk model in which 16 factors are identical or similar to EuroSCORE [1] factors. We may ask why the European model was not used alongside the new Italian model to see whether the authors' assertion that local models are superior is indeed supported by the data. Nevertheless, the . . . [Full Text of this Article]

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