Cardiac surgery mortality rates continue to decline

New Jersey’s sixth cardiac surgery report card shows that mortality rates continued to decline in 2001 to the lowest levels since reporting began in the state, Health and Senior Services Commissioner Clifton R. Lacy, M.D., announced yesterday.

Based on risk-adjusted data, New Jersey’s cardiac surgery patient mortality rate has declined about 45 percent since 1994-95, the time period covered by the state’s first report card.

Cardiac Surgery in New Jersey 2001: A Consumer Report reports on 30-day mortality rates for patients undergoing coronary artery bypass graft surgery. It includes data on overall statewide performance as well as data on individual surgeons and the 16 hospitals performing cardiac surgery in 2001. Englewood Hospital, which was licensed to perform cardiac surgery in July 2000, is included in the report for the first time.

“New Jersey continues to be a national leader in improving the quality of cardiac surgery care and promoting health care quality overall,” Commissioner Lacy said. “Because of the efforts of many physicians and hospitals over the years, and the support of the Cardiovascular Health Advisory Panel, New Jersey has been able to cut its cardiac surgery mortality rate nearly in half.

“This has occurred at the same time that patients are coming to cardiac surgery with more health conditions that put them at greater risk of dying,” the Commissioner added. “Many of the healthier patients are taking advantage of newer, less invasive treatments.”

New Jersey is one of four states to measure and report on cardiac surgery outcomes; New York, Pennsylvania and California are the other three.

In addition, New Jersey is one of only two states -- along with Pennsylvania -- to examine 30-day mortality. Thirty-day mortality, called “operative mortality” in New Jersey’s report, includes deaths within 30 days of surgery even if the patient died after discharge from the hospital, as well as deaths occurring during the hospital stay in which the surgery was performed, no matter how many days after the procedure.

According to the report released today, New Jersey’s statewide operative mortality rate for isolated bypass surgery was 2.51 percent in 2001, compared with 2.68 in 2000. In 1994-95, the rate was 4.14 percent.

The report includes statewide and hospital-by-hospital data based on 8,045 bypass procedures. There were 202 deaths within 30 days, or within the same hospitalization even if it extended beyond 30 days. The report also includes surgeon-specific performance data for 52 surgeons who performed at least 100 procedures in one hospital in 2000 and 2001 combined

All data are risk-adjusted to allow fair comparisons among hospitals and surgeons treating diverse patient populations. In effect, risk adjustment gives “extra credit” to hospitals or surgeons with sicker patient populations.

Fifteen hospitals had rates that were statistically the same as the statewide average. One hospital – Our Lady of Lourdes Medical Center – had a risk-adjusted mortality rate that was significantly higher than the state average.

Two surgeons – Dr. David Johnson at Jersey Shore University Medical Center and Dr. Eric Somberg at Hackensack University Medical Center -- had mortality rates significantly lower than the statewide average. The remaining surgeons had rates that were statistically the same as the statewide average.

The report card was produced in collaboration with the Cardiovascular Health Advisory Panel, a 17-member group of cardiologists, cardiac surgeons, hospital officials, and consumers that provides expert advice to the department on cardiovascular health issues, including technical matters relating to the release of the cardiac surgery report card.

“Through our close collaboration over the years, the Cardiovascular Health Advisory Panel and the department have developed a report card that is an important tool for promoting quality cardiac surgery around the state,” said Dr. Charles Dennis, CHAP Chairman and Chairman of the Department of Cardiovascular Diseases at the Deborah Heart and Lung Center.

“The report also gives consumers the data they need to make informed choices about cardiac surgery,” Dr. Lacy added. “The report card is one more resource consumers can use, along with their physician’s recommendation, in making decisions about where to have their surgery.”

The report is available on the department’s web site, www.state.nj.us/health/hcsa/cabmenu.htm