The mortality and re-admission rates for patients undergoing coronary artery bypass graft surgery and valve replacement continue to decline in Pennsylvania.
The new report by the Pennsylvania Health Care Cost Containment Council (PHC4) studied 20,164 patients who underwent bypass and/or valve replacement surgery in 50 Pennsylvania acute care hospitals between July 1, 2011 and Dec. 31, 2012.
- Statewide, the in-hospital mortality rate decreased from 1.9 percent to 1.5 percent for patients undergoing bypass surgery only.
- For valve surgery patients, in-hospital mortality rate fell from 3 percent to 2.3 percent.
- For patients undergoing bypass and valve replacement surgery, the mortality rate fell from 7.5 percent to 4.9 percent.
PHC4 Executive Director Joe Martin says the number of “open heart” surgeries are also declining. Bypass operations dropped by 19 percent from 2009 to 2012, and valve replacement surgeries decreased by 1.3 percent during that time period.
Martin said those undergoing the surgeries tend to be older and sicker.
“They have a more advanced illness level, and so despite those things — fewer patients, fewer procedures being done and more high risk patients, the mortality rates and readmission rates are still going down,” he said.
The reasons for the drop in “open heart” surgeries, according to Martin, it’s a greater public awareness of heart disease and symptoms as well as other options for all but the sickest patients.
“The advances in medical technology have made it possible to perform these kind of procedures (including angioplasty) without requiring long stays in the hospital, without requiring people’s chests to be cracked open and so it’s much less invasive," he said. "It’s much less intense, there are fewer complications, it’s less costly.”
Re-admissions within 30 days of the surgery is also declining, from 13.6 percent in 2005 to 11.8 percent in 2012 of patients who underwent bypass surgery only. For patients who had bypass and valve replacement operations, the re-admission rate fell from 19.2 percent to 17.8 percent.
“That’s a very tricky area to decide what exactly led to the readmission, “Martin said. “And is it linked directly to that procedure especially in an area like heart surgery. Cardiovascular disease is intertwined with so many other issues.”
According to Martin, it’s difficult to compare Pennsylvania’s hospitals’ performance with those in other states because there “are very few other states” that have similar public reporting mechanisms.
However, the New York Department of Health reports between 2008-2010 (most recent data available), the mortality rate for bypass and valve replacement patients in that state was 4.59 percent.