{"id":4111,"date":"1997-11-01T00:00:00","date_gmt":"1997-11-01T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/assessing-the-outcomes-of-coronary-artery-bypass-graft-surgery-how-many-risk-factors-are-enough\/"},"modified":"2023-06-14T20:12:00","modified_gmt":"2023-06-15T00:12:00","slug":"assessing-the-outcomes-of-coronary-artery-bypass-graft-surgery-how-many-risk-factors-are-enough","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/assessing-the-outcomes-of-coronary-artery-bypass-graft-surgery-how-many-risk-factors-are-enough\/","title":{"rendered":"Assessing the outcomes of coronary artery bypass graft surgery: how many risk factors are enough?"},"content":{"rendered":"<p><strong>Objectives<\/strong> &#x2014; We sought to determine whether more comprehensive risk-adjustment models have a significant impact on hospital risk-adjusted mortality rates after coronary artery bypass graft surgery (CABG) in Ontario, Canada. <\/p>\n<p><strong>Background<\/strong> &#x2014; The Working Group Panel on the Collaborative CABG Database Project has categorized 44 clinical variables into 7 core, 13 level 1 and 24 level 2 variables, to reflect their relative importance in determining short-term mortality after CABG. <\/p>\n<p><strong>Methods<\/strong> &#x2014; Using clinical data for all 5,517 patients undergoing isolated CABG in Ontario in 1993, we developed 12 increasingly comprehensive risk-adjustment models using logistic regression analysis of 6 of the Panel&apos;s core variables and 6 of the Panel&apos;s level 1 variables. We studied how the risk-adjusted mortality rates of the nine cardiac surgery hospitals in Ontario changed as more variables were included in these models. <\/p>\n<p><strong>Results<\/strong> &#x2014; Incorporating six of the core variables in a risk-adjustment model led to a model with an area under the receiver operating characteristic (ROC) curve of 0.77. The ROC curve area slightly improved to 0.79 with the inclusion of six additional level 1 variables (p = 0.063). Hospital risk-adjusted mortality rates and relative rankings stabilized after adjusting for six core variables. Adding an additional six level 1 variables to a risk-adjustment model had minimal impact on overall results. <\/p>\n<p><strong>Conclusions<\/strong> &#x2014; A small number of core variables appear to be sufficient for fairly comparing risk-adjusted mortality rates after CABG across hospitals in Ontario. For efficient interprovider comparisons, risk-adjustment models for CABG could be simplified so that only essential variables are included in these models.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives &#x2014; We sought to determine whether more comprehensive risk-adjustment models have a significant impact on hospital risk-adjusted mortality rates after coronary artery bypass graft surgery (CABG) in Ontario, Canada. Background &#x2014; The Working Group Panel on the Collaborative CABG Database Project has categorized 44 clinical variables into 7 core, 13 level 1 and 24 [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,25],"migration-helper-qa-sample-set":[],"class_list":["post-4111","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-surgery"],"acf":{"citation":"Tu JV, Sykora K, Naylor CD. <em>J Am Coll Cardiol.<\/em> 1997; 30(5):1317-23.","source_url":"http:\/\/ac.els-cdn.com\/S0735109797002957\/1-s2.0-S0735109797002957-main.pdf?_tid=431b31ac-2707-11e4-b734-00000aacb362&acdnat=1408387467_20a9b5412ab3a046b9169412ed10d352","ices_scientist":[1304],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"2151B2EF-CD95-4532-8437-F4A7AF4CAF8B","sitecore_item_name":"Assessing-the-outcomes-of-coronary-artery-bypass-graft-surgery-how-many-risk-factors","sitecore_field_values":"{\n  \"Title\": \"Assessing the outcomes of coronary artery bypass graft surgery: how many risk factors are enough?\",\n  \"Short title\": \"Assessing the outcomes of coronary\",\n  \"Citation\": \"<p>Tu JV, Sykora K, Naylor CD. <em>J Am Coll Cardiol.<\/em> 1997; 30(5):1317-23.<\/p>\",\n  \"Abstract\": \"<p><strong>Objectives<\/strong> &mdash; We sought to determine whether more comprehensive risk-adjustment models have a significant impact on hospital risk-adjusted mortality rates after coronary artery bypass graft surgery (CABG) in Ontario, Canada. <\/p>rn<p><strong>Background<\/strong> &mdash; The Working Group Panel on the Collaborative CABG Database Project has categorized 44 clinical variables into 7 core, 13 level 1 and 24 level 2 variables, to reflect their relative importance in determining short-term mortality after CABG. <\/p>rn<p><strong>Methods<\/strong> &mdash; Using clinical data for all 5,517 patients undergoing isolated CABG in Ontario in 1993, we developed 12 increasingly comprehensive risk-adjustment models using logistic regression analysis of 6 of the Panel's core variables and 6 of the Panel's level 1 variables. We studied how the risk-adjusted mortality rates of the nine cardiac surgery hospitals in Ontario changed as more variables were included in these models. <\/p>rn<p><strong>Results<\/strong> &mdash; Incorporating six of the core variables in a risk-adjustment model led to a model with an area under the receiver operating characteristic (ROC) curve of 0.77. The ROC curve area slightly improved to 0.79 with the inclusion of six additional level 1 variables (p = 0.063). Hospital risk-adjusted mortality rates and relative rankings stabilized after adjusting for six core variables. Adding an additional six level 1 variables to a risk-adjustment model had minimal impact on overall results. <\/p>rn<p><strong>Conclusions<\/strong> &mdash; A small number of core variables appear to be sufficient for fairly comparing risk-adjusted mortality rates after CABG across hospitals in Ontario. For efficient interprovider comparisons, risk-adjustment models for CABG could be simplified so that only essential variables are included in these models.<\/p>rn<p><a href=\"http:\/\/ac.els-cdn.com\/S0735109797002957\/1-s2.0-S0735109797002957-main.pdf?_tid=431b31ac-2707-11e4-b734-00000aacb362&amp;acdnat=1408387467_20a9b5412ab3a046b9169412ed10d352\" title=\"View full text\" target=\"_blank\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{5718D5DE-813C-4BEF-B244-C1252842E4D5}|{9F514AF9-2526-48FE-8414-54C443CF99AD}|{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}|{545C70EB-0A3F-4646-A0F5-509EB7E15CF6}\",\n  \"Posted Date\": \"19971101T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/1997\/January\/Assessing-the-outcomes-of-coronary-artery-bypass-graft-surgery-how-many-risk-factors"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Assessing the outcomes of coronary artery bypass graft surgery: how many risk factors are enough?<\/title>\n<meta name=\"description\" content=\"Objectives &#x2014; 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