Shahian D M, Williamson W A, Svensson L G, Restuccia J D, D'Agostino R S
Department of Thoracic and Cardiovascular Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.
Ann Thorac Surg. 1996 Nov;62(5):1351-8; discussion 1358-9. doi: 10.1016/0003-4975(96)00796-5.
Although originally developed for use in manufacturing statistical quality control techniques may be applicable to other frequently performed, standardized processes.
We employed statistical quality control charts (X- s, p, and u) to analyze perioperative morbidity and mortality and length of stay in 1,131 nonemergent, isolated, primary coronary bypass operations conducted within a 17-quarter time period.
The incidence of the most common adverse outcomes, including death, myocardial infarction, stroke, and atrial fibrillation, appeared to follow the laws of statistical fluctuation and were in statistical control. Postoperative bleeding, leg-wound infection, and the summation of total and major complications were out of statistical control in the early quarters of the study period but showed progressive improvement, as did postoperative length of stay.
The incidence of morbidity and mortality after primary, isolated, nonemergent coronary bypass operations may be described by standard models of statistical fluctuation. Statistical quality control may be a valuable method to analyze the variability of these adverse postoperative events over time, with the ultimate goal of reducing that variability and producing better outcomes.
尽管统计质量控制技术最初是为制造业开发的，但可能适用于其他经常执行的标准化流程。
我们使用统计质量控制图（X-s、p和u）分析了在17个季度内进行的1131例非急诊、孤立性、初次冠状动脉搭桥手术的围手术期发病率、死亡率和住院时间。
包括死亡、心肌梗死、中风和房颤在内的最常见不良结局的发生率似乎遵循统计波动规律，且处于统计控制范围内。术后出血、腿部伤口感染以及总并发症和主要并发症的总和在研究期的早期季度超出了统计控制范围，但显示出逐步改善，术后住院时间也是如此。
初次、孤立性、非急诊冠状动脉搭桥手术后的发病率和死亡率可以用统计波动的标准模型来描述。统计质量控制可能是一种有价值的方法，用于分析这些术后不良事件随时间的变异性，最终目标是减少这种变异性并产生更好的结果。
