Heart Surgery

Coronary Artery Bypass Graft (CABG) Surgery Outcomes Report from The Northern New England Cardiovascular Disease Study Group.

Members include cardiothoracic surgeons, interventional cardiologists, operating room and cardiac ICU nurses, anesthesiologists, perfusionists, administrators, and scientists associated with eight institutions in northern New England, including:

• Catholic Medical Center, Manchester, NH
• Central Maine Medical Center, Lewiston, ME
• Concord Hospital, Concord, NH
• Dartmouth-Hitchcock Medical Center, Lebanon, NH
• Eastern Maine Medical Center, Bangor, ME
• Fletcher Allen Health Care, Burlington, VT
• Maine Medical Center, Portland, ME
• Portsmouth Regional Hospital, Portsmouth, NH

Please Note:
These Study Group outcomes are part of an ongoing research study program and include only those patients who were admitted for their first CABG procedure, had no other procedures done during this surgery (such as a heart valve repair), and who had no other invasive treatment for this disease (such as an implanted stent) prior to the CABG procedure.

Based on the last three years, the average annual number of patients studied at the participating institutions was 2,583.

These outcomes include the most recent 500 patients who fit these criteria, through June 2005.

Coronary Artery Bypass Graft (CABG) Mortality Rate • A lower number is better What this Means: This measures the percent of hospitalized CABG patients1 in the Study Group who died following their procedure. Why this is important: A low mortality rate is an indicator of a good patient care process. This measure shows how Fletcher Allen compares with the Study Group result.

* Northern New England Cardiovascular Disease Study Group

Return to Operating Room for Post Operative Bleeding • A lower number is better What this Means: This measures the percent of CABG patients1 in the Study Group who needed to return to the operating room for open-chest surgery to control bleeding. Why this is important: A low rate of return to the operating room is an indicator of a good patient care process. This measure shows how Fletcher Allen compares with the Study Group result.

* Northern New England Cardiovascular Disease Study Group

Use of Mammary Artery • A higher number is better What this Means: This measures the percent of CABG patients1 in the Study Group whose mammary artery was grafted to bypass the blocked portion of a coronary artery during the procedure. Why this is important: A high mammary artery use rate is an indicator of a good patient care process. This measure shows how Fletcher Allen compares with the Study Group result. More about this measure

* Northern New England Cardiovascular Disease Study Group

Cerebrovascular Accident Rate • A lower number is better What this Means: This measures the percent of CABG patients1 in the Study Group who, following surgery, experienced a cerebrovascular accident (stroke) in which a new, unchanging neurological problem lasted at least 24 hours. Why this is important: A low cerebrovascular accident rate (stroke rate) is an indicator of a good patient care process. This measure shows how Fletcher Allen compares with the Study Group result.

* Northern New England Cardiovascular Disease Study Group

Chest Incision Complications • A lower number is better What this Means: This measures the percent of CABG patients1 in the Study Group who experienced a serious incision infection that resulted in additional surgery being required. Why this is important: A low complication rate is an indicator of a good patient care process. This measure shows how Fletcher Allen compares with the Study Group result.

* Northern New England Cardiovascular Disease Study Group

¹ CABG patients for these studies were those patients who were admitted for their first CABG procedure, had no other procedures done during this surgery (such as a heart valve repair), and who had no other invasive treatment for this disease (such as an implanted stent) prior to this CABG procedure. Based on the last three years, the average annual number of patients studied in this category at all the participating institutions was 2,583. This number includes the most recent 500 patients who fit the above criteria at Fletcher Allen through June 2005.

² Confidence Intervals - Each medical center participating in the Study Group uses statistical analysis to learn if its own patient care outcomes are different from the Study Group as a whole. Outcomes could be better or worse than those for the entire Group-wide population of similar patients. These statistical measures help physicians and researchers evaluate patient care outcomes for each institution and compare them to the results of the entire Study Group. In this way, the knowledge of entire Study Group is advanced, benefiting the patients at each participating institution. For example the mortality rate for CABG patients (see note 1 above) throughout the Study Group was 2.6% for the time period. The mortality rate at Fletcher Allen’s was 2.4%.