NEW YORK-The state has issued hospital-specific statistics on angioplasty mortality that don’t seem to mean very much.
Trouble is, according to the state health department report, death is so rare during PTCA that there’s not much to compare. Overall mortality for the 18,558 patients at 32 hospitals in 1994 was 0.87%. After adjusting for differences between the hospitals, the state found no significant differences in mortality between any of the hospitals.
Except one, which has an aggressive, high-profile cath lab. And that one, Lenox Hill here, is crying foul.
In 1,187 angioplasties done there, 17 patients died. Lenox Hill, the first hospital in the city to use stents, and others have criticized the state’s methods as inadequate and unfair. They distort the truth, says Dr. Jeffrey Moses, Lenox Hill’s chief of interventional cardiology. Dr. Moses also decried the use of statistics for one year only, calling the excess in 1994 a statistical bleep.
Others sympathized. NYU’s Dr. Frederick Feit says the state’s methods penalize hospitals that treat large numbers of high-risk patients.
Also, he says, the equation used to adjust for risks is too imprecise. Although a patient with an ejection fraction below 20 is considered to be at elevated risk, no difference is allowed for a patient with an EF of 30, vs. a patient with an EF of 70.
Several other hospitals had higher mortality rates, but because of smaller numbers of cases these differences did not reach significance.
Dr. Mark Chassin of Mount Sinai, who initiated the PTCA data release when he was state health commissioner, called the report “an important first step.” But, he said, the reports will be more useful when they include nonfatal outcomes. -Larry Husten
NEW YORK-The state has issued hospital-specific statistics on angioplasty mortality that don’t seem to mean very much.
