For bypass graft mortality without stroke, no hospital performed significantly better than the state average. But Enloe Medical Center in Sacramento, Los Angeles Co. Harbor—UCLA Medical Center, St. Joseph's Medical Center in Stockton and Valley Presbyterian Hospital in Van Nuys, performed significantly worse.
The California agency keeps the largest public outcomes database in the country and is an important source of comparative information for performance.
Other significant findings from the report include the following:
This latest report also scored hospitals on their use of the internal mammary artery (IMA) during CABG procedures, a practice associated with better surgical outcomes but may take longer. Five hospitals had low rates of IMA usage, including Citrus Valley Medical Center in Covina, Dameron Hospital in Stockton, Lakewood Regional Medical Center in Lakewood, Suttter Medical Center in Santa Rosa and Tri-City Medical Center in Oceanside.
Parker says that use of the IMA in bypass graft surgery is longer lasting and is associated with lower mortality, but takes about 15 minutes longer to perform than traditional use of the radial artery or saphenous vein, and that may be why some surgeons fail to use it. In 2007, the state had a 93.7% IMA usage, a 4% increase since 2003.
With its next report the state hopes to add in comparative data on how many CABG patients go into renal failure and require post-operative dialysis, another complication. Renal failure occurs in between 1% and 2% of CABG cases, on average, he says.
Debby Rogers, vice president for Quality and Emergency Services for the California Hospital Association, says her organization is "pleased that they're issuing reports with more recent data." She noted that the reports indicate a distinct "through the years that care is improving" related to CABG mortality.