{"id":3449,"date":"1998-08-11T00:00:00","date_gmt":"1998-08-11T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/the-improving-outcomes-of-coronary-artery-bypass-graft-surgery-in-ontario-1981-to-1995\/"},"modified":"2023-06-14T19:19:55","modified_gmt":"2023-06-14T23:19:55","slug":"the-improving-outcomes-of-coronary-artery-bypass-graft-surgery-in-ontario-1981-to-1995","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-improving-outcomes-of-coronary-artery-bypass-graft-surgery-in-ontario-1981-to-1995\/","title":{"rendered":"The improving outcomes of coronary artery bypass graft surgery in Ontario, 1981 to 1995"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; There is continuing uncertainty over the relative contribution of outcomes monitoring to changes in surgical outcomes over time. The authors studied temporal trends in the clinical characteristics and short-term outcomes of patients who underwent coronary artery bypass grafting (CABG) in Ontario before and after the implementation, in 1993, of a province-wide program to provide feedback on cardiac surgery outcomes.<\/p>\n<p><strong>Methods<\/strong> &#x2014; The authors analysed data from hospital discharge abstracts on the clinical characteristics and in-hospital death rates of all 67,784 patients who underwent isolated CABG in Ontario between Apr. 1, 1981, and Mar. 31, 1996.<\/p>\n<p><strong>Results<\/strong> &#x2014; Death rates were relatively stable during the first half of the 1980s, then declined gradually in the second half of the decade; this decline continued into the first half of the 1990s. In the 1990s patients were older than those in the 1980s, and a higher proportion had coexisting diseases. Between 1986\/87 and 1995\/96 the unadjusted death rate decreased by 52% (5.0% v. 2.4%) (p &lt; 0.001). The annual relative rate of decline was approximately 6% (95% confidence interval 5% to 7%) in the period before the outcomes feedback program was implemented and about 9% (95% confidence interval 7% to 11%) in the period after implementation.<\/p>\n<p><strong>Interpretation<\/strong> &#x2014; Rates of death after CABG have been declining steadily in Ontario since the mid-1980s. Outcomes-based quality improvement interventions may facilitate; but are not a prerequisite for, improvements in the quality of surgical care.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; There is continuing uncertainty over the relative contribution of outcomes monitoring to changes in surgical outcomes over time. The authors studied temporal trends in the clinical characteristics and short-term outcomes of patients who underwent coronary artery bypass grafting (CABG) in Ontario before and after the implementation, in 1993, of a province-wide program to [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,62,25],"migration-helper-qa-sample-set":[],"class_list":["post-3449","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-health-services-research","topic-surgery"],"acf":{"citation":"Tu JV, Wu K. <em>CMAJ<\/em>. 1998; 159(3):221-7.","source_url":"http:\/\/www.cmaj.ca\/content\/159\/3\/221.reprint","ices_scientist":[],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"789322C1-8305-4822-9EDA-06954D31E6D7","sitecore_item_name":"The-improving-outcomes-of-coronary-artery-bypass-graft-surgery-in-Ontario-1981-to-1995","sitecore_field_values":"{\n  \"Title\": \"The improving outcomes of coronary artery bypass graft surgery in Ontario, 1981 to 1995\",\n  \"Short title\": \"The improving outcomes of coronary\",\n  \"Citation\": \"<p>Tu JV, Wu K. <em>CMAJ<\/em>. 1998; 159(3):221-7.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; There is continuing uncertainty over the relative contribution of outcomes monitoring to changes in surgical outcomes over time. The authors studied temporal trends in the clinical characteristics and short-term outcomes of patients who underwent coronary artery bypass grafting (CABG) in Ontario before and after the implementation, in 1993, of a province-wide program to provide feedback on cardiac surgery outcomes.<\/p>n<p><strong>Methods<\/strong> &mdash; The authors analysed data from hospital discharge abstracts on the clinical characteristics and in-hospital death rates of all 67,784 patients who underwent isolated CABG in Ontario between Apr. 1, 1981, and Mar. 31, 1996.<\/p>n<p><strong>Results<\/strong> &mdash; Death rates were relatively stable during the first half of the 1980s, then declined gradually in the second half of the decade; this decline continued into the first half of the 1990s. In the 1990s patients were older than those in the 1980s, and a higher proportion had coexisting diseases. Between 1986\/87 and 1995\/96 the unadjusted death rate decreased by 52% (5.0% v. 2.4%) (p &lt; 0.001). The annual relative rate of decline was approximately 6% (95% confidence interval 5% to 7%) in the period before the outcomes feedback program was implemented and about 9% (95% confidence interval 7% to 11%) in the period after implementation.<\/p>n<p><strong>Interpretation<\/strong> &mdash; Rates of death after CABG have been declining steadily in Ontario since the mid-1980s. Outcomes-based quality improvement interventions may facilitate; but are not a prerequisite for, improvements in the quality of surgical care.<\/p>n<p><a href=\"http:\/\/www.cmaj.ca\/content\/159\/3\/221.reprint\" title=\"External link opens\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{9F514AF9-2526-48FE-8414-54C443CF99AD}|{A39C5396-16B7-4369-B0F9-31F6E91E46FC}|{92E2791D-5DAB-4244-8A85-434D524D9A12}\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{956599EC-5699-41D3-9375-E0B6C25B12D5}\",\n  \"Posted Date\": \"19980811T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/1998\/January\/The-improving-outcomes-of-coronary-artery-bypass-graft-surgery-in-Ontario-1981-to-1995"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | The improving outcomes of coronary artery bypass graft surgery in Ontario, 1981 to 1995<\/title>\n<meta name=\"description\" content=\"Background &#x2014; There is continuing uncertainty over the relative contribution of outcomes monitoring to changes in surgical outcomes over time. 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