Failure to Rescue - a Closer Look at Mortality Rates Has No Added Value for Hospital Comparisons but Is Useful for Team Quality Assessment in Abdominal Aortic Aneurysm Surgery in The Netherlands

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
N LijftogtDutch Institute for Clinical Auditing

Abstract

Failure to rescue (FTR) is a composite quality indicator, defined as the proportion of deceased patients following major complications. The aims of this study were to compare FTR with mortality for hospital comparisons in abdominal aortic aneurysm (AAA) surgery in The Netherlands and investigate hospital volume and associated factors. Patients prospectively registered between 2013 and 2015 in the Dutch Surgical Aneurysm Audit (DSAA) were analysed. FTR was analysed for AAA patients and subgroups elective (EAAA) and acute (AAAA; symptomatic or ruptured) aneurysms. Variables and hospital volume were analysed by uni- and multivariable regression analysis. Adjusted hospital comparisons for mortality, major complications, and FTR were presented in funnel plots. Isomortality lines were constructed when presenting FTR and major complication rates. A total of 9258 patients were analysed in 61 hospitals: 7149 EAAA patients (77.2%) and 2109 AAAA patients (22.8%). There were 2785 (30.1%) patients with complications (unadjusted range 5-65% per hospital): 2161 (77.6%) with major and 624 (28.4%) patients with minor complications. Overall mortality was 6.6% (adjusted range 0-16% per hospital) and FTR was 28.4% (n = 613) (adjusted range 0-60% p...Continue Reading

Citations

Feb 2, 2019·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Andrés Reyes ValdiviaClaudio Gandarias Zúñiga
Sep 17, 2019·International Psychogeriatrics·Teresa MayordomoAlicia Sales
Sep 25, 2019·The Journal of Vascular Access·Miltos K LazaridesGeorge S Georgiadis
Dec 29, 2019·Scientific Reports·Constance J H C M van LaarhovenSander W van der Laan
Apr 21, 2021·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Anna J AlbergaUNKNOWN Dutch Institute for Clinical Auditing
Jul 2, 2021·Journal of Vascular Surgery·Gerdine C I von MeijenfeldtMaarten J van der Laan

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