Variations in complication rates and opportunities for improvement in quality of care for patients having abdominal aortic surgery

摘要: Background. The purpose was to assess the current variation in complication rates and evaluate association between specific types of complications in-hospital mortality total hospital charges for patients having abdominal aortic surgery. Patients/methods. We studied 2987 surgery Maryland from 1994 1996 used discharge diagnoses procedure codes identify that most likely represent major complications. evaluated how related complications, adjusting patient demographics, severity illness, comorbidity, surgeon volumes. Discharge data obtained marketing departments. Results. Complication varied widely among hospitals. Complications independently associated with increased risk death include cardiac arrest an odds ratio (OR) 90 a 95% confidence interval (CI) 32–251, septicemia (OR 6.1, CI 3.3–11.3), acute myocardial infarction 5.7, 2.3–14.3), renal failure 5.0, 2.3–11.0), surgical after 3.1, 2.0–4.9), reoperation bleeding 2.2, 1.1–4.8). population-attributable 47% 27% failure. Conclusions. In on Maryland, some vary are (charges differ costs). Efforts reduce these should help decrease both levels.