Heart Bypass Surgery Death Rates Drop Sharply in the U.S.

The proportion of patients who died in the hospital after having coronary artery bypass graft (CABG) surgery fell from 42 deaths per 1,000 admissions in 2000 to 24 per 1,000 in 2006, a drop of 43%, according to a new report.

Researchers at the U.S. Agency for Healthcare Research and Quality (AHRQ; Rockville, MD, USA) reported that rural hospitals experienced the greatest improvement (92%), although their rate of 38 deaths per 1,000 admissions was still higher than for other hospitals; suburban hospitals near large metropolitan areas had the lowest rate (21 per 1,000 admissions). Hospitals in counties with small cities (fewer than 50,000 residents) were the only ones that reported an increase in heart bypass surgery death rates between 2000 and 2006 (28 versus 31 per 1,000 admissions).

The AHRQ also found that in 2006, the CABG surgery death rate for women remained higher (35 per 1,000 admissions) than for men (20 per 1,000 admissions). Uninsured patients had the lowest heart bypass surgery death rate (23 deaths per 1,000 admissions), followed by privately insured, Medicare, and Medicaid patients (24, 24.5, and 28 deaths per 1,000 admissions, respectively). The report was published in the August 3, 2010, issue of AHRQ News and Numbers, and it is based on the 2009 National Healthcare Disparities Report, which examined the disparities in Americans' access to and quality of health care, with breakdowns by race, ethnicity, income, and education.

Heart failure is the most common cause of death among CABG patients, due to myocardial infarction (MI) related to embolism, hypoperfusion, or graft failure. Other reasons for death following CABG are acute renal failure due to embolism or hypoperfusion; stroke, secondary to embolism or hypoperfusion; excessive bleeding; and infection.

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Agency for Healthcare Research and Quality