EVALUATION OF COMPLICATION RATES AFTER CORONARY-ARTERY BYPASS-SURGERYUSING ADMINISTRATIVE DATA

Our objectives were (1) to determine if studying hospital complication rates after coronary artery bypass graft (CABG) surgery provides info rmation not available when only mortality is studied, and (2) to reexp lore the utility of ICD-9-CM administrative data for CABG outcomes ass essment. Using data from Massachusetts, we identified CABG cohorts fro m 1990 and 1992 to respectively develop and validate multivariate risk adjustment models predicting in-hospital mortality and complications. The resulting models had good discrimination and calibration. In 1992 , adjusted hospital complication rates ranged widely from 13.0% to 57. 6%, while mortality rates ranged from 1.4% to 6.1%. Hospitals with hig h complication rates tended to have high mortality (r = 0.74, p = 0.00 6), but 2 of the 12 hospitals studied ranked quite differently when ju dged by complications rather than mortality. We conclude that (1) comp lications after CABG occur frequently and may provide information abou t hospital quality beyond that obtained from hospital mortality rates, and that (2) administrative data continue to be a promising resource for outcomes research.