Sharp declines in hospital death rates in 2004

Sharp declines in the hospital death rates of patients from heart attack and five other leading conditions meant that an estimated 136,000 who would have died had they been hospitalized a decade earlier survived their stays in 2004, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

AHRQ compared the death rates for 1994 and 2004 for patients who were hospitalized for heart attack, congestive heart failure, stroke, pneumonia, gastrointestinal hemorrhage, or hip fracture.

For every 1,000 patients admitted for their condition:

• Heart attack deaths fell by 43; deaths from congestive heart failure, pneumonia, and stroke each dropped roughly 30;
• Deaths from gastrointestinal hemorrhage declined by 21; and
• 16 fewer died from hip fracture.

For every 1,000 patients who underwent six surgical procedures examined:

• Abdominal aortic aneurysm repair deaths plunged from 103 to 74;
• Deaths from craniotomy – an operation for brain lesions and other conditions – declined from 83 to 68;
• Deaths from heart bypass surgery fell from 48 to 28, angioplasty deaths diminished from 16 to 12, those from carotid endarterectomy – an operation to avert stroke – fell from 12 to 7, and
• Deaths from hip replacement surgery declined by half – from 4 to 2 per every 1,000 operations.

The death rates for the six conditions and six surgical procedures are risk-adjusted, meaning that AHRQ's researchers took into account differences in how ill patients were over time when calculating the results.

This AHRQ News and Numbers is based on data in Trends in Hospital Risk-Adjusted Mortality for Select Diagnoses and Procedures, 1994-2004. The report uses statistics from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. The authors used AHRQ's Inpatient Quality Indicators to determine the in-hospital, risk-adjusted death rates.