Measuring the Quality of Treatment and Outcomes for Patients with Aneurysms at the Cedars-Sinai Department of Neurosurgery

A brain aneurysm is an abnormal bulging of one of the arteries in the brain. Aneurysms are classified as ruptured or unruptured and are treated by a clipping or coiling procedure. Clipping is a surgical procedure in which a clip is placed across the neck of the aneurysm to stop or prevent an aneurysm from bleeding. Coiling is a minimally invasive endovascular procedure; during coiling, tiny coils are packed into the aneurysm to promote blood clotting and close off the aneurysm.

As part of its ongoing focus on continually improving the care given to patients with aneurysms, the Cedars-Sinai Department of Neurosurgery monitors:

  • The volume of aneurysms treated at Cedars-Sinai
  • Mortality rates for patients who underwent the clipping procedure for ruptured aneurysms before after discharge from Cedars-Sinai Medical Center
  • Mortality rates for patients who underwent the coiling procedure for ruptured aneurysms before discharge from Cedars-Sinai.

The data shown in the graphs below comes from the University Health System Consortium (UHC), an alliance of 120 academic medical centers and 301 of their affiliated hospitals representing the nation's major academic medical centers. Most of these facilities participate in UHC's Clinical DataBase/Resource Manager. The data were assessed on April 28, 2014 based on patients discharged between January 1, 2011 through December 31, 2013.

Volume of Aneurysms Treated at the Cedars-Sinai Department of Neurosurgery

The graph below shows the total number of aneurysm repairs performed annually at Cedars-Sinai, using both clipped and coiled procedures. Many patients have multiple aneurysms repaired at a time.

 

30 Day Mortality Rate for Patients Undergoing Clipping Procedure to Treat a Ruptured Aneurysm

The observed percent mortality is the actual number of patients that expired within 30 days after hospital discharge divided by the total number of patients who had the same procedure. The expected percent mortality is the number of patients anticipated to expire divided by the total number of patients who had similar diagnosis, procedure, age, gender and complications. The graph below illustrates the difference between the observed percent mortality and the expected percent mortality of coiled patients that expired by year. 

A lower observed 30 day mortality rate is better than a higher one.

 

30 Day Mortality Rate for Patients Undergoing a Coiling Procedure to Treat a Ruptured Aneurysm

The graph below compares actual (or observed) rates of patients dying before discharge from Cedars-Sinai Medical Center following a coiling procedure for a ruptured aneurysm with the mortality rate that would have been expected from patients of similar gender and age who had similar diagnoses, procedures and complications.

A lower observed 30 day mortality rate is better than a higher one.

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