Table 1 –
Overall Team Familiarity Terciles | |||||
---|---|---|---|---|---|
Variable | Overall | Low (1.0–17.0) | Medium (17.2–27.2) | High (>27.2) | p-trend |
Frequency | 4445 | 1474 | 1486 | 1485 | |
Provider Experience, years | |||||
Surgeon | 12.18 [5.83, 21.92] | 6.70 [1.45, 14.85] | 13.82 [10.40, 21.30] | 20.94 [9.16, 24.28] | <.0001 |
Anesthesiologist | 4.37 [2.16, 10.55] | 4.10 [2.01, 10.63] | 4.38 [2.20, 10.31] | 4.65 [2.30, 10.62] | 0.0829 |
Perfusionist | 4.22 [1.31, 16.78] | 3.72 [0.90, 20.50] | 4.42 [1.39, 17.50] | 4.34 [1.66, 10.45] | 0.0249 |
Physician Assistant | 20.55 [5.25, 26.66] | 19.08 [4.29, 25.66] | 20.11 [4.73, 26.79] | 24.21 [12.85, 27.09] | <.0001 |
Surgical resident experience (if present) | 5.61 [2.82,6.88] | 5.37 [2.70,6.65] | 5.62 [2.80,6.99] | 5.73 [2.98,6.91] | 0.0185 |
Surgical Resident Present, % yes | 2507 (56.4) | 757 (51.4) | 900 (600.6) | 850 (57.2) | <.0001 |
Surgeon volume 2 yr prior to the surgery (Median [IQR]) | 355.00 [324.00, 435.00] | 326.00 [177.00, 368.50] | 387.00 [339.00, 447.75] | 370.00 [337.00, 436.00] | <.0001 |
EuroSCORE-II (Median [IQR]) (%) | 3.91 [1.65,9.54] | 4.63 [1.99, 10.33] | 3.61 [1.52,9.40] | 3.58 [1.51,9.22] | <.0001 |
<.0001 | |||||
low (<2.2%) | 1485 (33.4) | 415 (28.2) | 522 (35.1) | 548 (36.9) | |
medium (2.2–6.9%) | 1478 (33.3) | 519 (35.2) | 489 (32.9) | 470 (31.6) | |
high (>6.9 %) | 1482 (33.3) | 540 (36.6) | 475 (32.0) | 467 (31.4) | |
Demographics | |||||
Age (median [IQR]) | 63.00 [54.00, 71.00] | 64.00 [55.00, 71.00] | 64.00 [54.00, 71.00] | 63.00 [52.00, 71.00] | 0.0192 |
Male, % yes | 2921 (65.7) | 1039 (70.5) | 938 (63.1) | 944 (63.6) | <.0001 |
Body Surface Area, m2 | |||||
Median [IQR] | 2.04 [1.86, 2.22] | 2.06 [1.89, 2.25] | 2.03 [1.85, 2.21] | 2.02 [1.84, 2.21] | 0.0001 |
0.0194 | |||||
<1.6 | 223 (5.0) | 61 (4.1) | 86 (5.8) | 76 (5.1) | |
1.6–1.8 | 636 (14.3) | 191 (13.0) | 218 (14.7) | 227 (15.3) | |
1.8–2.0 | 1091 (24.5) | 343 (23.3) | 359 (24.2) | 389 (26.2) | |
>=2.0 | 2495 (56.1) | 879 (59.6) | 823 (55.4) | 793 (53.4) | |
Risk Factors | |||||
Diabetes on insulin, % yes | 399 (9.0) | 146 (9.9) | 127 (8.5) | 126 (8.5) | 0.1771 |
Poor Mobility, % yes | <.0001 | ||||
None | 1916 (43.1) | 722 (49.0) | 614 (41.3) | 580 (39.1) | |
<6 sec | 1733 (39.0) | 527 (35.8) | 599 (40.3) | 607 (40.9) | |
>=6 sec | 796 (17.9) | 225 (15.3) | 273 (18.4) | 298 (20.1) | |
Cardiovascular Disease | |||||
Renal Impairment, % yes | 0.7434 | ||||
Normal | 2326 (52.3) | 789 (53.5) | 770 (51.8) | 767 (51.6) | |
Moderately Impaired Renal Function (50–85 ml/min) | 1602 (36.0) | 519 (35.2) | 546 (36.7) | 537 (36.2) | |
Severely Impaired Renal Function (<50 ml/min) off Dialysis | 412 (9.3) | 138 (9.4) | 132 (8.9) | 142 (9.6) | |
On Dialysis | 105 (2.4) | 28 (1.9) | 38 (2.6) | 39 (2.6) | |
Chronic Lung Disease (moderate and severe), % yes | 287 (6.5) | 111 (7.5) | 94 (6.3) | 82 (5.5) | 0.0263 |
Extracardiac Arteriopathy, % yes | <.0001 | ||||
None | 3208 (72.2) | 1004 (68.1) | 1062 (71.5) | 1142 (76.9) | |
Peripheral Arterial Disease | 615 (13.8) | 262 (17.8) | 188 (12.7) | 165 (11.1) | |
Carotid Occlusion or >50% Stenosis | 622 (14.0) | 208 (14.1) | 236 (15.9) | 178 (12.0) | |
Active Endocarditis, % yes | 182 (4.1) | 67 (4.5) | 50 (3.4) | 65 (4.4) | 0.8202 |
Canadian Cardiovascular Society Class 4 angina, % yes | 700 (15.7) | 312 (21.2) | 203 (13.7) | 185 (12.5) | <.0001 |
NY Heart Association Class, % yes | 0.0026 | ||||
None | 2573 (57.9) | 920 (62.4) | 813 (54.7) | 840 (56.6) | |
Class I | 150 (3.4) | 48 (3.3) | 52 (3.5) | 50 (3.4) | |
Class II | 779 (17.5) | 217 (14.7) | 279 (18.8) | 283 (19.1) | |
Class III | 613 (13.8) | 194 (13.2) | 215 (14.5) | 204 (13.7) | |
Class IV | 330 (7.4) | 95 (6.4) | 127 (8.5) | 108 (7.3) | |
Left Ventricular Ejection Fraction, % yes | 0.3466 | ||||
>50% | 3434 (77.3) | 1137 (77.1) | 1133 (76.2) | 1164 (78.4) | |
31–50% | 644 (14.5) | 229 (15.5) | 218 (14.7) | 197 (13.3) | |
21–30% | 157 (3.5) | 50 (3.4) | 57 (3.8) | 50 (3.4) | |
<20% | 210 (4.7) | 58 (3.9) | 78 (5.2) | 74 (5.0) | |
Recent Myocardial Infarction (within 21d), % yes | 1589 (35.7) | 571 (38.7) | 527 (35.5) | 491 (33.1) | 0.0013 |
Pulmonary Hypertension, % yes | <.0001 | ||||
Normal or | 2244 (50.5) | 766 (52.0) | 718 (48.3) | 760 (51.2) | |
Unknown | |||||
Moderate (Systolic 31–55mmHg) | 1662 (37.4) | 577 (39.1) | 567 (38.2) | 518 (34.9) | |
Severe (Systolic >55mmHg) | 539 (12.1) | 131 (8.9) | 201 (13.5) | 207 (13.9) | |
Acuity, % yes | <.0001 | ||||
Elective | 3247 (73.0) | 973 (66.0) | 1109 (74.6) | 1165 (78.5) | |
Emergent | 222 (5.0) | 133 (9.0) | 58 (3.9) | 31 (2.1) | |
Urgent | 976 (22.0) | 368 (25.0) | 319 (21.5) | 289 (19.5) | |
Previous Cardiac Surgery, % yes | 1913 (43.0) | 617 (41.9) | 612 (41.2) | 684 (46.1) | 0.0208 |
Procedure | |||||
Surgery Type, % yes | <.0001 | ||||
Isolated | 669 (15.1) | 304 (20.6) | 221 (14.9) | 144 (9.7) | |
Single, Non Coronary Artery Bypass Grafting | 2460 (55.3) | 799 (54.2) | 781 (52.6) | 880 (59.3) | |
2–3 procedures | 882 (19.8) | 235 (15.9) | 324 (21.8) | 323 (21.8) | |
Other | 434 (9.8) | 136 (9.2) | 160 (10.8) | 138 (9.3) | |
Surgery on Thoracic Aorta, % yes | 1147 (25.8) | 572 (38.8) | 299 (20.1) | 276 (18.6) | <.0001 |
Day of the Week (%) | |||||
Sunday | 101 (2.3) | 50 (3.4) | 35 (2.4) | 16 (1.1) | |
Monday | 853 (19.2) | 314 (21.3) | 292 (19.7) | 247 (16.6) | |
Tuesday | 941 (21.2) | 276 (18.7) | 264 (17.8) | 401 (27.0) | |
Wednesday | 806 (18.1) | 342 (23.2) | 314 (21.1) | 150 (10.1) | |
Thursday | 833 (18.7) | 216 (14.7) | 262 (17.6) | 355 (23.9) | |
Friday | 791 (17.8) | 223 (15.1) | 276 (18.6) | 292 (19.7) | |
Saturday | 120 (2.7) | 53 (3.6) | 43 (2.9) | 24 (1.6) | |
Procedure Start Time (%) | <.0001 | ||||
Afternoon | 924 (20.8) | 315 (21.4) | 352 (23.7) | 257 (17.3) | |
Evening | 103 (2.3) | 50 (3.4) | 38 (2.6) | 15 (1.0) | |
Morning | 3324 (74.8) | 1048 (71.1) | 1071 (72.1) | 1205 (81.1) | |
Overnight | 94 (2.1) | 61 (4.1) | 25 (1.7) | 8 (0.5) | |
Year (%) | <.0001 | ||||
2016 | 521 (11.7) | 143 (9.7) | 171 (11.5) | 207 (13.9) | |
2017 | 1016 (22.9) | 295 (20.0) | 354 (23.8) | 367 (24.7) | |
2018 | 1189 (26.7) | 479 (32.5) | 342 (23.0) | 368 (24.8) | |
2019 | 1214 (27.3) | 404 (27.4) | 457 (30.8) | 353 (23.8) | |
2020 | 505 (11.4) | 153 (10.4) | 162 (10.9) | 190 (12.8) |
Poor Mobility - Measured using the average of three 5-meter walk tests
Chronic Lung Disease - long term use of bronchodilators or steroids for lung disease
Active Endocarditis - patient still on antibiotic treatment for endocarditis at time of surgery
To test the trend of these variables across the ordered team familiarity terciles, the Cochran-Armitage trend tests were used for the binary variables, Cochran-Mantel_Haenszel tests were used for the categorical variables with more than two levels, Jonckheere-Terpstra trend tests were used for the continuous variables.