California Cardiac Surgery Intervention Project

Summary of Isolated CABG Model based on California Inpatient Discharge Data, 2013-2014

Outcome:Mortality
Mortality includes death during the surgery admission, death during a connected subsequent acute inpatient admission, or death at an emergency department encounter or inpatient re-admission within 30 days of the index surgery Only patients are included who did not leave against medical advice after the surgery admission and who were residents of California at the time of the surgery,
Model Statistics:
Number of Observations: 23,045
% of Observations with Outcome: 2.3%
C-statistic: 0.763Pseudo-R2: 11.0Hosmer-Lemeshow P-Value: 0.218
Model Details:
Risk Factor N Cases % Events Estimate Standard Error Wald Chi2 P-value Odds Ratio (OR) Lower 95% CL for OR Upper 95% CL for OR
Intercept
-5.0
0.2
1070.0
0.000
Age at Admission18-<50
1,774
1.6
-0.2
0.2
0.5
0.477
0.8
0.5
1.3
50-<55
1,619
1.5
-0.3
0.3
1.1
0.296
0.8
0.5
1.3
55-<60
2,971
1.7
-0.1
0.2
0.5
0.500
0.9
0.6
1.3
60-<65
3,750
2.0
0.1
0.2
0.1
0.717
1.1
0.8
1.5
65-<70
4,418
1.9
Reference
70-<75
3,470
2.5
0.2
0.2
1.6
0.200
1.2
0.9
1.7
75-<80
2,828
2.7
0.3
0.2
2.5
0.114
1.3
0.9
1.8
80 or older
2,215
4.7
0.7
0.2
19.4
0.000
2.0
1.5
2.7
Patient SexMale
17,669
1.9
Reference
Female
5,376
3.6
0.6
0.1
32.0
0.000
1.7
1.4
2.1
RaceOther race
3,513
2.5
0.1
0.1
1.1
0.305
1.2
0.9
1.5
White
15,498
2.2
Reference
Black
980
2.6
0.0
0.2
0.0
0.944
1.0
0.7
1.6
Asian/Pacific Islander
3,054
2.6
0.2
0.1
2.3
0.129
1.2
0.9
1.6
EthnicityHispanic
4,863
2.2
0.0
0.1
0.1
0.754
1.0
0.7
1.2
Non-Hispanic
18,182
2.3
Reference
Acute MI Present at Scheduled Admission
1,242
2.2
0.2
0.2
1.2
0.270
1.3
0.8
1.9
Acute MI Present at Unscheduled Admission
7,337
3.7
0.5
0.1
25.6
0.000
1.7
1.4
2.1
Aortic/Mitral Valve Disease/Stenosis/Insufficiency
272
5.2
0.4
0.3
2.1
0.148
1.5
0.9
2.7
Atrial Fibrillation and Flutter
2,642
3.4
0.1
0.1
0.3
0.577
1.1
0.8
1.4
Cardiogenic Shock
669
10.4
1.1
0.2
50.1
0.000
3.0
2.2
4.1
Cardiomyopathy
1,202
4.0
0.4
0.2
4.7
0.031
1.4
1.0
2.0
Heart Failure
5,381
4.2
0.5
0.1
19.9
0.000
1.6
1.3
1.9
HX Sudden Cardiac Arrest (Begin 2007)
145
2.1
0.0
0.6
0.0
0.940
1.0
0.3
3.1
Chronic Lung Disease
2,985
3.0
0.2
0.1
2.6
0.106
1.2
1.0
1.6
Cerebrovascular Disease
1,850
3.2
0.2
0.1
2.0
0.154
1.2
0.9
1.7
Diabetes
11,638
2.3
-0.1
0.1
1.7
0.186
0.9
0.7
1.1
Dialysis
622
6.2
0.5
0.2
5.5
0.019
1.6
1.1
2.3
Number of GraftsOne
1,078
4.1
0.5
0.2
9.5
0.002
1.7
1.2
2.4
Two
3,810
3.0
0.3
0.1
8.2
0.004
1.4
1.1
1.7
Three or More
18,157
2.0
Reference
PCI prior to Admission
4,241
2.2
0.0
0.1
0.0
0.935
1.0
0.8
1.3
Prior PCI on same Day as Surgery
333
10.1
1.0
0.2
17.8
0.000
2.6
1.7
4.1
Pre-Op Intra-Aortic Balloon Pump
1,652
5.0
0.3
0.2
4.3
0.038
1.4
1.0
2.0
Prior CABG/Valve Surgery
443
5.1
0.8
0.2
11.0
0.001
2.2
1.4
3.4
Peripheral Vascular Disease
3,987
3.0
0.1
0.1
0.3
0.572
1.1
0.9
1.3
Renal Failure
5,099
4.3
0.7
0.1
41.3
0.000
2.0
1.6
2.4
Status of Procedure Urgent
691
7.1
0.5
0.2
5.5
0.019
1.6
1.1
2.5
Notes:
If a patient had more than one surgery event of the same type on different dates during the index admission, only the surgery on the earliest date is included for fitting the model.
CL: Confidence Limit
CABG: Coronary Artery Bypass Graft
PCI: Percutaneous Coronary Intervention