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Cardiac surgery
Original research article
Falling hospital and postdischarge mortality following CABG in New South Wales from 2000 to 2013
  1. David B Brieger1,
  2. Austin C C Ng2,
  3. Vincent Chow3,
  4. Mario D'Souza1,
  5. Karice Hyun1,
  6. Paul G Bannon4 and
  7. Leonard Kritharides1
  1. 1Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia
  2. 2Department of Cardiology, Concord Hospital and The University of Sydney, Concord, New South Wales, Australia
  3. 3Department of Cardiology, Concord Hospital, The University of Sydney and ANZAC Medical Research Institute, Sydney, New South Wales, Australia
  4. 4Cardiothoracic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  1. Correspondence to Dr David B Brieger; david.brieger{at}health.nsw.gov.au

Abstract

Objectives To describe changes in mortality among patients undergoing coronary artery bypass grafting (CABG) in New South Wales (NSW) Australia from 2000 to 2013.

Methods Patients undergoing CABG were identified from the NSW Admission Patient Data Collection (APDC) registry, linked to the NSW state-wide death registry database. Changes in all-cause mortality over time were observed following stratification of the study cohort into two year groups.

Results We identified 54 767 patients undergoing CABG during the study period. The risk profile of patients increased over time with significant increases in age, comorbidities and concomitant valve surgery (all p < 0.0001). During a median follow-up period of 6 years, a total 12 161 (22.2%) of patients had died. Survival curves and adjusted analyses showed a steady fall in mortality rate: those operated on during 2012–2013 had 40 % lower mortality than those operated on during 2000–2001 (HR 0.61; 95% CI 0.53 to 0.69). This was contributed to both by a fall in mortality both in hospital (HR 0.48, 95% CI 0.37 to 0.62) and postdischarge (HR 0.73; 95% CI 0.61 to 0.86).

Conclusions We report a consistent reduction in medium-term mortality among a large unselected cohort of NSW patients undergoing CABG between 2000 and 2013. This fall is attributable both to an improvement in outcomes in hospital and in the postdischarge period.

  • coronary artery bypass grafting
  • coronary artery disease

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/openhrt-2018-000959

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    Footnotes

    • Contributors Planning of the study: DB, AN and MD. Performance of the analyses: MD and KH. Reporting of the work: DB, AN, VC, MD, KH, PB and LK. Responsible for overall content: DB.

    • Funding Funding for data linkage was provided by the Department of Cardiology, Concord hospital.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.