3 ms·

A mortality rate of 0.7% for elective procedures sounds high. What counts as elective but carries such risk? Is it similar in other countries?

dokein 7y ago
Anything that is scheduled in advance (i.e. not imminently life or limb-threatening) is elective. That includes most transplants, coronary bypasses, removing a tumor from the brain etc.
bosie 7y ago
They aren't measuring the mortality rate of the procedure. they are measuring this: "Death in or out of hospital within 30 days of the procedure." If I am already on my death bed (for lack of better word), the procedure's mortality rate is probably not swaying it much. Also, couldn't find if they would include something like a lethal car accident 28 days after the procedure or not. > An elective procedure was defined as “elective: from waiting list,” “elective: booked,” or “elective: planned” High risk procedures seem to be cancer related and specific excisions.
- tomrod 7y ago
  If one uses an "episode of care" framework, mortality within 30 days of treatment is a standard metric. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Episode-Costs-and-Medicare-Episode-Grouper https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Paymen...
- Fomite 7y ago
  Things like getting hit by a car are referred to as "competing risks". The authors lumped all deaths together: "We defined the mortality outcome as any death occurring within 30 days..." But there are other ways to handle this, with increasing levels of annoyance/sophistication.
LorenPechtel 7y ago
The problem is "elective" has a different meaning in doctor-speak than in common usage. "Elective" doesn't mean it's something you can reasonably decide to have or not, in doctor-speak it's the opposite of emergency. If it's put on the schedule rather than done stat it's elective, no matter how serious the procedure.

dokein 7y ago

Anything that is scheduled in advance (i.e. not imminently life or limb-threatening) is elective. That includes most transplants, coronary bypasses, removing a tumor from the brain etc.

bosie 7y ago

They aren't measuring the mortality rate of the procedure. they are measuring this: "Death in or out of hospital within 30 days of the procedure." If I am already on my death bed (for lack of better word), the procedure's mortality rate is probably not swaying it much. Also, couldn't find if they would include something like a lethal car accident 28 days after the procedure or not. > An elective procedure was defined as “elective: from waiting list,” “elective: booked,” or “elective: planned” High risk procedures seem to be cancer related and specific excisions.

tomrod 7y ago
If one uses an "episode of care" framework, mortality within 30 days of treatment is a standard metric. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Episode-Costs-and-Medicare-Episode-Grouper https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Paymen...
Fomite 7y ago
Things like getting hit by a car are referred to as "competing risks". The authors lumped all deaths together: "We defined the mortality outcome as any death occurring within 30 days..." But there are other ways to handle this, with increasing levels of annoyance/sophistication.

LorenPechtel 7y ago

The problem is "elective" has a different meaning in doctor-speak than in common usage. "Elective" doesn't mean it's something you can reasonably decide to have or not, in doctor-speak it's the opposite of emergency. If it's put on the schedule rather than done stat it's elective, no matter how serious the procedure.