Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Jan 2014
Observational StudyInter-relationship of procedural mortality rates in vascular surgery in England: retrospective analysis of hospital episode statistics from 2005 to 2010.
Wide variations in vascular surgical outcomes have been demonstrated in England. The objective of this study was to determine whether risk-adjusted postoperative mortality rates for elective and emergency vascular surgical procedures were inter-related. ⋯ Hospital-level risk-adjusted mortality for both elective and emergency vascular procedures in England varies considerably, and providers were globally high or low performers. The data should be made available to patients, relatives, and the purchasers of services to drive improvements in the provision of vascular surgical services.
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Circ Cardiovasc Qual · Jan 2014
Low-dose aspirin and upper gastrointestinal bleeding in primary versus secondary cardiovascular prevention: a population-based, nested case-control study.
The benefit-risk profile of low-dose aspirin in primary prevention of cardiovascular disease is unclear. We sought to quantify upper gastrointestinal bleeding (UGIB) risk associated with low-dose aspirin in secondary versus primary prevention patients. ⋯ The relative risk of UGIB in patients taking low-dose aspirin is higher when used for primary than for secondary cardiovascular disease prevention, but this difference is more than compensated by the lower baseline risk in the primary prevention population. Such estimates are important for an assessment of the net clinical benefit in primary prevention.
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Circ Cardiovasc Qual · Jan 2014
Comparative StudyHow accurate is the eyeball test?: a comparison of physician's subjective assessment versus statistical methods in estimating mortality risk after cardiac surgery.
In the era of increasing percutaneous treatment options for heart disease, the estimation of surgical risk has become a key factor in selecting optimal treatment strategies. Surgical risk has historically been estimated by physician's subjective assessment and more recently by statistical risk estimates. ⋯ In patients undergoing cardiac surgery, statistical risk estimate is a better method to predict operative and long-term mortality compared with physician's subjective risk estimate. However, both methods modestly overestimate actual operative mortality risk.