NDLI: Inter-relationship of procedural mortality rates in vascular surgery in England: retrospective analysis of hospital episode statistics from 2005 to 2010.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sinha, S. Karthikesalingam, A. Poloniecki, J. D. Thompson, M. M. Holt, P. J.
Spatial Coverage	England
Description	Country affiliation: United kingdom Author Affiliation: Sinha S ( Department of Outcomes Research, St George's University of London, London, UK.)
Abstract	BACKGROUND: Wide variations in vascular surgical outcomes have been demonstrated in England. The objective of this study was to determine whether risk-adjusted postoperative mortality rates for elective and emergency vascular surgical procedures were inter-related. METHODS AND RESULTS: A retrospective observational study using National Health Service administrative data on adult patients undergoing elective or emergency vascular surgery from 2005 to 2010. The 10 procedures covered the broad spectrum of workload for a vascular surgical service. The primary outcome measure was in-hospital mortality, and secondary outcomes were 30-day and 1-year mortality. Data were risk-adjusted using multilevel modeling. Analyses comprised a 2-level basket designed to evaluate variations in outcome and whether the outcome of each procedure could be predicted by the composite outcome of all other procedures. A total of 116,596 vascular surgical procedures were performed across 166 providers. For 9 of 10 procedures, there were hospitals lying outside 95% control limits for ≥1 mortality outcome. The key finding was that ≥1 risk-adjusted mortality outcome for any 1 of the 9 vascular surgical procedures could be predicted by the aggregated within provider performance of the other vascular surgical procedures combined. CONCLUSIONS: Hospital-level risk-adjusted mortality for both elective and emergency vascular procedures in England varies considerably, and providers were globally high or low performers. The data should be made available to patients, relatives, and the purchasers of services to drive improvements in the provision of vascular surgical services.
File Format	HTM / HTML
ISSN	19417713
e-ISSN	19417705
Journal	Circulation: Cardiovascular Quality and Outcomes
Issue Number	1
Volume Number	7
Language	English
Publisher	American Heart Association
Publisher Date	2014-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Cardiology Discipline Vascular Diseases Aortic Aneurysm, Abdominal Epidemiology Surgery Elective Surgical Procedures Mortality Emergency Treatment State Medicine Statistics & Numerical Data Vascular Surgical Procedures Endarterectomy, Carotid Hospital Mortality Outcome Assessment (health Care) Retrospective Studies Risk Factors Survival Rate Observational Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine

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