Faizabadi Sanam, Farshid Amirali, Dadkhah Parisa Alsadat, Yaghoubi Shayan, Khademi Reza, Zebardast Khorrami Shakiba, Asadi Alireza, Garmsiri Arta, Zabihi Nima, Khazaei Pool Sareh, Talebian Niki, Falah Tafti Mahdi, Alizadeh Alaleh, Asadi Anar Mahsa, Deravi Niloofar
Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences Shiraz, Iran.
Student Research Committee, School of Medicine, Ardabil University of Medical Sciences Ardabil, Iran.
Am J Cardiovasc Dis. 2025 Jun 15;15(3):195-211. doi: 10.62347/TYLZ6475. eCollection 2025.
Coronary artery disease and valvular heart disease are leading causes of mortality globally. This study aimed to investigate the correlation between expected mortality rates (EMRs) and observed mortality rates (OMRs) for common cardiac interventions using recent national data on percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and cardiac valve surgeries.
This multi-institutional, retrospective observational study analyzed in-hospital/30-day mortality outcomes for 106,836 patients who underwent PCI, CABG, or cardiac valve procedures across 64 non-federal hospitals in New York State between December 2012 and November 2015. The procedures included emergency and non-emergency PCI, CABG, valve or valve-CABG surgeries, and transcatheter aortic valve replacement (TAVR).
Among the 106,836 patients, a 3.21% 30-day mortality rate was observed (n=3,436). To assess the disparity between OMR and EMR, a one-sample t-test was performed. Effect sizes were determined using Cohen's d and Hedges' correction. With a 95% confidence interval, the t-value for the OMR (mean difference =2.037±1.728, CI: 1.95-2.12) was 47.270, whereas the EMR (mean difference =1.930±1.284, CI: 1.86-1.99) yielded a t-value of 60.279. The OMR was significantly greater than the EMR (P<0.001).
The OMR was significantly greater than the EMR across all cardiac procedures, suggesting potential influences from patient demographics, comorbidities, and variations in hospital practices. Further research is needed to understand these factors and improve the quality of cardiac care.
冠状动脉疾病和心脏瓣膜病是全球主要的死亡原因。本研究旨在利用近期关于经皮冠状动脉介入治疗（PCI）、冠状动脉旁路移植术（CABG）和心脏瓣膜手术的全国数据，调查常见心脏干预措施的预期死亡率（EMR）与观察到的死亡率（OMR）之间的相关性。
这项多机构回顾性观察研究分析了2012年12月至2015年11月期间纽约州64家非联邦医院中106,836例接受PCI、CABG或心脏瓣膜手术患者的住院/30天死亡率结果。这些手术包括急诊和非急诊PCI、CABG、瓣膜或瓣膜 - CABG手术以及经导管主动脉瓣置换术（TAVR）。
在106,836例患者中，观察到30天死亡率为3.21%（n = 3,436）。为评估OMR和EMR之间的差异，进行了单样本t检验。使用Cohen's d和Hedges'校正确定效应大小。在95%置信区间下，OMR的t值（平均差异 = 2.037±1.728，CI：1.95 - 2.12）为47.270，而EMR（平均差异 = 1.930±1.284，CI：1.86 - 1.99）的t值为60.279。OMR显著高于EMR（P<0.001）。
在所有心脏手术中，OMR均显著高于EMR，这表明患者人口统计学特征、合并症以及医院实践差异可能产生影响。需要进一步研究以了解这些因素并改善心脏护理质量。
