{"doi":"10.1016/j.xjon.2023.10.014","title":"Hospital characteristics associated with failure to rescue in cardiac surgery","abstract":"Objective The study objective was to examine the association between hospital processes of care and failure to rescue in a diverse, multi-institutional cardiac surgery network. Methods Failure to rescue was defined as an operative mortality after 1 or more of 4 complications: prolonged ventilation, stroke, renal failure, and unplanned reoperation. Society of Thoracic Surgeons data from 20,950 consecutive patients in the Columbia HeartSource network who underwent 1 of 7 cardiac operations—coronary artery bypass grafting, aortic valve replacement ± coronary artery bypass grafting, mitral valve repair or replacement ± coronary artery bypass grafting—were analyzed to calculate failure to rescue rates. Hospital-specific characteristics were ascertained by survey method. Multivariable mixed-effects logistic models assessed the association of these hospital characteristics with failure to rescue while adjusting for patient-related factors known to be associated with mortality. Results Failure to rescue rates at affiliate hospitals ranged from 5.45% to 21.74% (median, 12.5%; interquartile range, 6.9%). When controlling for Society of Thoracic Surgeons–predicted risk of mortality with hospital as a random effect, 4 hospital characteristics were found to be associated with lower failure to rescue rates; the presence of cardiac-trained anesthesiologists (odds ratio, 0.41; CI, 0.31-0.55, P < . 001), availability of extracorporeal membrane oxygenation mechanical circulatory support (odds ratio, 0.41; CI, 0.31-0.54, P < . 001), ratio of intensive care unit beds to intensivists (odds ratio, 0.87; CI, 0.76-0.99, P = . 039), and total number of intensive care unit beds (odds ratio, 0.97; CI, 0.96-0.99, P = . 002) Conclusions In a diverse multi-institutional cardiac surgical network, we were able to identify specific hospital processes of care associated with failure to rescue, even when adjusting for patient-related predictors of operative mortality.","journal":"JTCVS Open","year":2023,"id":351837,"datarank":0.5131715970660033,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.16778383311689637,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.16778383311689637,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":9,"citers_with_citation_signal":4,"citers_with_endowment":4,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7324,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":975811,"name":"Jocelyn Sun","orcid":"0000-0003-4493-4430","position":1,"is_corresponding":false},{"id":1097393,"name":"Susan Schnell","orcid":null,"position":2,"is_corresponding":false},{"id":1097394,"name":"Emily Guderian","orcid":null,"position":3,"is_corresponding":false},{"id":1096874,"name":"Charles A. Mack","orcid":"0000-0001-8142-9818","position":4,"is_corresponding":false},{"id":446983,"name":"Michael Argenziano","orcid":"0000-0003-3374-9037","position":5,"is_corresponding":false},{"id":678280,"name":"Paul Kurlansky","orcid":"0000-0003-2681-9885","position":6,"is_corresponding":false},{"id":494218,"name":"Gabriela O. Escalante","orcid":"0000-0002-0085-7966","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:12:45.897709Z","pmid":"38204725","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}