Deaths in NJ After Bypass Surgery Drops
By LINDA A. JOHNSON
TRENTON, N.J. – The death rate from heart bypass surgery done at New Jersey hospitals fell nearly 12 percent in 2004 and has been cut in half in the decade the state has been publicizing outcomes, the latest report shows.
On average, 2 percent of the 6,177 patients who had heart bypass surgery in 2004 died in the hospital or within 30 days of their surgery, according to a state report released Wednesday. That was down from more than 4 percent in 1994-95, when the first report was done by the state Department of Health and Senior Services.
The new state report gives death rates, the number of operations performed and average length of stay for the 17 hospitals that did bypass surgery in 2004 – the most recent year for which figure were available – along with details on the performance of 49 heart surgeons at the different hospitals.
"The bottom line is, New Jersey hospitals are doing well and continue to improve," said state health commissioner Dr. Fred M. Jacobs.
One facility, Englewood Hospital and Medical Center, had no deaths after its 102 bypass surgeries. Hackensack University Medical Center and Newark Beth Israel Medical Center both had mortality rates below 1 percent, and most other hospitals were clustered between just over 1 percent and 3 percent.
Jacobs credits the annual reports for at least part of the decline in death rates, saying hospitals want to do well compared to their competition. In addition, his department works with hospitals with poor results on implementing correction plans.
"I think there’s room for improvement yet," Jacobs said.
He points to two hospitals with significantly worse rates than the state average: University Hospital in Newark, with a mortality rate of 6.8 percent, and Our Lady of Lourdes Medical Center in Camden, at 4.5 percent.
University Hospital spokeswoman Anna Farneski said the hospital had no deaths among heart surgery patients in 2005 and 2006.
"We’re very proud of the progress University Hospital has made since 2004," she said.
Lourdes spokeswoman Wendy Marano noted the data is three years old. She said the hospital did a thorough review of its cardiac surgery program in 2005 and made changes the next year, including bringing in a new chief of vascular surgery and barring one surgeon with poor results from doing any more bypasses.
"There’s been a steady improvement since we implemented the changes," Marano said.
The data is so old because of the time needed to review each patient’s medical records, among other analysis, Jacobs said. The mortality rates are also adjusted to account for differences in how sick the patients are, he said.
On average, bypass patients spent about 6 days in the hospital.
The report also notes the continuing decline in the number of bypass operations, from 8,377 in 1998 to 6,177 in 2004, due to the increasing use of angioplasty. During the less-invasive angioplasty procedure, a catheter is threaded up into a clogged artery and a balloon on the end is inflated to push down the plaque.
However, the shift to fewer bypass surgeries is an issue because studies have repeatedly shown that practice makes perfect; surgical teams performing many bypass operations generally have better outcomes than low-volume surgery programs.
New Jersey is one of just five states that publicly report on the outcomes of cardiac surgery. The others are Pennsylvania, New York, Massachusetts and California.
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On the Net:
Surgery report: http://www.nj.gov/health/healthcarequality/documents/cardconsumer04.pdf