Use of hierarchical models to evaluate performance of cardiac surgery centres in the Italian CABG outcome study
2007

Evaluating Cardiac Surgery Centre Performance in Italy

Sample size: 34310 publication 10 minutes Evidence: moderate

Author Information

Author(s): D'Errigo Paola, Tosti Maria E, Fusco Danilo, Perucci Carlo A, Seccareccia Fulvia

Primary Institution: Istituto Superiore di Sanità, Rome, Italy

Hypothesis

How do differences between cardiac surgery centres affect adjusted mortality rates after CABG surgery?

Conclusion

The study found that 10.1% of the variability in adjusted mortality rates after CABG surgery can be attributed to differences between cardiac surgery centres.

Supporting Evidence

  • 34,611 subjects underwent CABG, with a mortality rate of 2.61%.
  • 10.1% of total variability in mortality was explained by differences between centres.
  • The correlation coefficient between classical and hierarchical model results was 0.99.

Takeaway

This study looked at how well different heart surgery hospitals perform by checking how many patients died after surgery. It found that where you get surgery can really change your chances of surviving.

Methodology

A hierarchical regression model was built using data from the Italian CABG outcome study, analyzing mortality rates across 64 cardiac surgery centres.

Potential Biases

Potential bias due to the collection of hospital characteristics for purposes other than this study.

Limitations

The study may overestimate the importance of clinical centres if important individual-level covariates were omitted.

Participant Demographics

The mean age of participants was 67.4 years, with 80% male and various comorbidities including diabetes and recent infarction.

Statistical Information

P-Value

0.35

Confidence Interval

1.06 – 1.08

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1471-2288-7-29

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