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Applications of statistical quality control to cardiac surgery
D M Shahian1, W A Williamson, L G Svensson
1Department of Thoracic and Cardiovascular Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.
The Annals of Thoracic Surgery
|November 1, 1996
Summary
Statistical quality control (SQC) charts effectively monitored coronary bypass surgery outcomes. While most adverse events remained stable, complications like bleeding and infection improved over time, demonstrating SQC
Area of Science:
- Cardiovascular Surgery
- Quality Improvement Science
- Biostatistics
Background:
- Statistical quality control (SQC) methods, initially for manufacturing, show potential in standardizing healthcare processes.
- Analyzing perioperative outcomes requires robust statistical methodologies.
Purpose of the Study:
- To assess the applicability of SQC charts in analyzing perioperative morbidity, mortality, and length of stay for coronary bypass surgery.
- To identify trends and variability in adverse outcomes following primary coronary bypass operations.
Main Methods:
- Utilized X-bar and s, p, and u control charts to analyze data from 1,131 coronary bypass operations over 17 quarters.
- Focused on nonemergent, isolated, primary coronary artery bypass grafting (CABG) procedures.
Main Results:
- Common adverse events (death, myocardial infarction, stroke, atrial fibrillation) were within statistical control.
- Postoperative bleeding, leg-wound infection, and overall complication rates were initially out of control but improved.
- Postoperative length of stay also demonstrated progressive improvement over the study period.
Conclusions:
- Morbidity and mortality following primary CABG can be described by statistical fluctuation models.
- SQC charts are valuable tools for analyzing and reducing variability in adverse postoperative events, leading to improved patient outcomes.