Heart Surgeries at UMass Memorial Medical Center Halted Due to High Death Rate

As a result of an unusually high number of deaths since 2003 following cardiac bypass operations, UMass Memorial Medical Center stopped performing open heart surgeries this week.

According to an analysis by state public health officials, the hospital’s death rate for coronary artery bypass surgery patients was almost twice the average for hospitals in Massachusetts.

Doctors at UMass hospital have reportedly known about problems in the cardiac surgery program for two years, but have not taken any action until now, after the analysis was presented by state officials.

The state Department of Public of Health has enlisted three heart surgeons from other  hospitals to determine whether the death rate can be lowered, or whether the high mortality rate result from uncontrollable factors like race and class.

A probe will also be conducted by the Division of Health Care Quality to determine exactly when hospital executives became aware of the high mortality rate, and what they did to address it.

The president of UMass Memorial Medical Center, Dr. Walter Ettinger, Jr., has said that in 2003, physicians and hospital executives realized that the mortality rate for patients who had undergone bypass surgery and died within 30 days of their operations was around twice the state average (more than 4 %, compared to an average of 2-2.5 %).

Hospital officials also realized that the rate of chest infections among heart patients was high as well (6.4 % compared to an average of 1-4 %).

Hospital executives then hired outside consultants to examine the cardiac surgery program and recommend improvements. A number of changes in procedure were made as a result of the review, Ettinger said, including making sure patients received antibiotics through an I.V. within an hour before surgery begins.

According to hospital president, after the changes were adopted in 2004, the hospital’s chest infection rate lowered to 1.5 %. But the death rate has not been reduced.

During 2003, out of 371 cases, 16 patients who had coronary bypass surgery at the hospital died within 30 days of their surgery. Throughout Massachusetts, 99 patients died out of 4,393 cases. UMass had similar death rates in 2002, 2004, and 2005.

The mortality rates for the 13 hospitals in the state that perform cardiac surgery were made available to the public by health officials last October in an effort to aid patients with making decisions about where to get care and in order to motivate hospitals to improve their statistics.

The scenario at UMass, a teaching hospital, again calls attention to the lag in time between hospital reporting and public reporting of patient and death statistics.

It is not known when UMass Memorial Medical Center will reopen its heart surgery program.

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