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A Third of In-Hospital Deaths After CABG Were Preventable

Majority of preventable deaths due to problems in the operating room and the intensive care unit

WEDNESDAY, June 11 (HealthDay News) -- Approximately one-third of in-hospital deaths following coronary artery bypass graft surgery (CABG) were preventable and occurred regardless of hospitals' low all-cause mortality rates, according to a report in the June 10 issue of Circulation: Journal of the American Heart Association.

Veena Guru, M.D., of the Institute for Clinical Evaluative Services Toronto in Canada, and colleagues undertook a retrospective analysis of 347 randomly selected, in-hospital deaths following CABG at nine hospitals in Ontario between 1998 and 2003. Two cardiac surgeons reviewed the patient records to determine if the deaths were preventable, and a third reviewer assessed cases in which the first two reviewers disagreed.

Of 347 deaths, the surgeon-reviewers found 32 percent to be preventable, with no correlation between hospitals' risk-adjusted mortality rates (which ranged from 1.3 to 3.1 percent) and the proportion of preventable deaths, the researchers report. A majority of preventable deaths occurred due to problems in the operating room and the intensive care unit -- 86 percent and 61 percent, respectively. Many of the deaths occurred after providers deviated from standard care, the report indicates.

"We hope our data will provide an impetus for regions to create an infrastructure to initiate similar, detailed adverse event audits, along with quality improvement initiatives to respond to audit results," the authors conclude.

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