Enhancing outcomes in unfavorable circumstances is the current issue of cardiac surgery (CS). In the biggest CS center in Latin America, researchers for a study sought to determine how a quality improvement program (QIP) affected hospital mortality.
Patients were separated into 2 groups: before the creation of the QIP (Jan 2013–Dec 2015, n = 3,534) and after (Jan 2017–Dec 2019, n = 3,544). Ten core projects were implemented as part of the QIP in 2016. The operations considered were solitary coronary artery bypass grafting (CABG), mitral valve, aortic valve, combined mitral and aortic valve, and CABG accompanied with heart valve surgery. To account for differences in the preoperative characteristics of patients before and after the deployment of QIP, Propensity Score Matching (PSM) was utilized. Utilizing discrimination and calibration measures, a multivariate logistic regression model was created to forecast hospital mortality.
Using 5 characteristics, the PMS matched two groups to produce 858 patients who had operations previously (non-QIP) and 858 patients who had operations after the QIP’s adoption. The length of stay was reduced in all hospitalization phases when comparing the QIP group to the Non-QIP group. Additionally, the patients’ anemia (P = 0.001), intra-aortic balloon pump usage (P = 0.003), atrial fibrillation (P = 0.001), acute renal damage (P< 0.001), cardiogenic shock (P = 0.011), sepsis (P = 0.046), and hospital mortality (P = 0.001) decreased with time. The absence of QIP raised the odds of mortality among the predictors of hospital mortality by 2.09 times in the multiple models.
After the investigated cardiac procedures, there was a decrease in hospital stay, complications, and mortality following the deployment of the first CS QIP in Latin America.
Reference: sciencedirect.com/science/article/pii/S1743919122007087
