This Article Full Text (PDF) References 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 Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Klein, A. A. Articles by Nashef, S. A. M. Search for Related Content PubMed PubMed Citation Articles by Klein, A. A. Articles by Nashef, S. A. M. Social Bookmarking                   What's this?

Perception and Reporting of Cardiac Surgical Performance

Departments of Anesthesia, Papworth Hospital, Cambridge, United Kingdom, Andrew.Klein{at}papworth.nhs.uk

Samer A. M. Nashef, MD

Department of Surgery, Papworth Hospital, Cambridge, United Kingdom

The high level of interest in surgical outcomes has led to the publication of mortality rates in the public domain. In cardiac surgery, the availability of quite sophisticated risk assessment has allowed these outcomes to be adjusted for risk. The European System for Cardiac Operative Risk Evaluation is a widely recognized and used risk scoring system and has been used and validated throughout Europe and beyond. The logistic version is now the most commonly applied, but recalibration may be required. The methodology and statistics for measuring risk-adjusted performance are available, and regular audit and performance monitoring should be carried out in all cardiac surgical units. In the United Kingdom, risk-adjusted outcomes are available and regularly updated on the Internet. Presentation of data may be improved by the use of variable life-adjusted display curves. League tables for crude mortality can be misleading and should be avoided. When properly conducted, the measurement of risk-adjusted surgical outcomes should improve quality control and decision making and allow early identification of poor performance. Quality monitoring in medicine is a priority, and similar methods can be employed in other specialties, including anesthesia, by establishing and analyzing risk-stratified outcome data sets.

Key Words: performance • EuroScore • risk

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 12, No. 3, 184-190 (2008)
DOI: 10.1177/1089253208323414


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				T. L. Higgins Metrics That Matter: Can Transparency Fix the Health Care System? Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2008; 12(3): 137 - 139. [PDF]