Follow-Up After Cardiac Surgery Should be Extended to at Least 120 Days When Benchmarking Cardiac Surgery Centers

Relocation of patients after cardiac surgery: is it worth the effort?

“…If detected early, it could be possible to avoid hospitalisation altogether. Recent findings demonstrate a continuous high rate of complications and deaths up to 120 days after surgery supporting the demand for frequent treatment adjustments in the post‐operative period. In conjunction with present results, we suggest that many patients would gain from early and frequent follow‐up to allow for titration of anti‐congestive treatment, patient education and early detection of complications.…”

Use of 90-day mortality does not change assessment of hospital quality after coronary artery bypass grafting in New York State

“…90 days) outcomes as markers of surgical success. 13,14 Part of the rationale for focusing on a longer period of follow-up is that this approach may improve the ability to recognize low quality of care after discharge, and therefore provide useful information to individual patients who are deciding to pursue care at a given institution. 13 Conversely, extending follow-up periods may capture mortality unrelated to the procedure itself, may intimidate patients who interpret a larger number as an outsize risk, and may create a standard for follow-up that is more costly to implement without sufficient benefit.…”

“…13,14 Part of the rationale for focusing on a longer period of follow-up is that this approach may improve the ability to recognize low quality of care after discharge, and therefore provide useful information to individual patients who are deciding to pursue care at a given institution. 13 Conversely, extending follow-up periods may capture mortality unrelated to the procedure itself, may intimidate patients who interpret a larger number as an outsize risk, and may create a standard for follow-up that is more costly to implement without sufficient benefit. Prior studies have demonstrated that mortality increases dramatically when the follow-up period is extended from 30 to 90 days following major surgery, with approximate doubling of mortality rates after Whipple, esophagectomy, or lung resection procedures (100%, 92.9%, and 111.9% increases between 30 to 90 day mortality rates, respectively), [23][24][25] without high correlation of the two metrics.…”

“…12 In critically ill patients, a population with high rates of use of life-sustaining therapy and discharge to facilities, recognition of the limits of short-term mortality has resulted in the use of longerterm mortality measured at 90 days, as this may represent a more meaningful time frame for both patients and clinicians. 13,14 Presumably, 90-day follow-up periods are of sufficient length to capture additional outcomes related to a given condition or procedure, yet do not extend follow-up into a timeframe where unrelated events are inappropriately attributed to a particular acute episode. Thus, we sought to determine whether use of 90-day versus 30-day postoperative mortality after coronary artery bypass graft surgery would change assessments of institutional performance in NYS.…”

Stand und Perspektiven einer sektorenübergreifenden Qualitätssicherung

“…Die Identifikation des geeigneten Intervalls erfordert indikatorenspezifische Festlegungen. Selbst für weltweit fast schon als "Standard" anzusehende Follow-up-Indikatoren wie die 30-Tage-Sterblichkeit nach herzchirurgischen Eingriffen zeigen Analysen, dass diese teilweise zu hinterfragen sind -dass aber auch für längere Follow-up-Intervalle eine Zuschreibbarkeit zur Indexleistung möglich ist (Siregar et al 2013;Hansen et al 2015;Hirji et al 2019).…”