Safe Launching of a Newly Appointed Cardiac Surgery Unit at a Low-Volume Hospital With the Use of Cumulative Sum Analysis

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Background Few studies have used the cumulative sum method to examine the initial performance of a newly appointed cardiac surgery team at a low-volume hospital. Methods and Results In the 4 years from April 2002 to December 2006, 274 cases of open-heart surgery were performed and the overall mortality and morbidity rates were 4.01% and 5.84%, respectively. The respective rates for coronary, valvular and aortic surgery were 2.05% and 2.74%, 3.61% and 7.23%, and 11.1% and 13.3%. The overall cumulative sum curve was below the 80% upper alarm line since the 58^<th> case and below the 80% lower alarm line since the 139^<th> case. The respective values for the cumulative sum curves of valvular and coronary surgery were the 1^<st> and 41^<st> cases, the 22^<nd> and the 76^<th> cases, but for aortic surgery the cumulative sum curve remained below the 80% upper alarm line since the 1^<st> case but did not reach below the 80% lower alarm line Conclusions An open-heart surgery unit at a low-volume hospital could compete with a high-volume hospital if it has a safe launching and low mortality and morbidity rates. The predictor of a safe launching is not the annual volume, but the cumulative experience of the surgical team.
社団法人日本循環器学会の論文
2008-02-20