USE OF A NATIONAL DATA-BASE TO ASSESS PERIOPERATIVE RISK, MORBIDITY, MORTALITY, AND COST SAVINGS IN CORONARY-ARTERY BYPASS-GRAFTING

To show the usefulness of the Society of Thoracic Surgeons (STS) Natio nal Database in providing clinical and cost-related outcome data, we s tudied 297 consecutive patients who had isolated coronary artery bypas s grafting (CABG) and who were assigned to either a ''fast track'' or traditional track. The observed overall mortality rate was 2.7%. The p redicted mortality based on preoperative risk factors was 4.7%. Before the initiation of a ''fast-track'' protocol and critical pathways, th e average length of stay was 8.2 days and the average cost of uncompli cated isolated CABG was $18,476. The length of postoperative stay and the cost decreased to 6.0 days and $12,427, respectively, with the app lication of a fast-track protocol (when appropriate) and critical path ways without affecting clinical outcomes. Use of the STS National Data base provided rapid and reassessing evidence that survival and quality of care were not compromised with implementation of a cost-saving fas t-track protocol and critical pathways.