TRENTON –   New Jersey’s hospitals continue to provide consumers high-quality cardiac surgical care, Health and Senior Services Commissioner Fred M. Jacobs M.D., J.D., announced today in releasing the eighth cardiac surgery report.

According to Cardiac Surgery in New Jersey 2003: A Consumer Report, patient mortality rates have declined by 50 percent since 1994 when reporting began.

“Cardiac surgery is far less risky than it was a decade ago,” Commissioner Jacobs said.  “This can be attributed to hospitals’ and surgeons’ efforts to make surgery safer.  And it proves the value of New Jersey’s commitment to public data reporting as a way to spur improvement in health care quality.

“New Jersey will continue to lead the way in giving consumers solid data they can use to help make important health care decisions for themselves and their families,” he added.

“The Cardiovascular Health Advisory Panel appreciates the opportunity to collaborate with the department on this important initiative,” said Dr. Charles Dennis, Chairman of CHAP, a 20-member expert panel that advises the department on cardiac health care issues.  “We are proud to be part of a program that has had such positive results.”

Dr. Dennis is also Chairman of the Department of Cardiovascular Diseases at Deborah Heart and Lung Center in Browns Mills.

The report released today includes performance data for 17 hospitals performing cardiac surgery in 2003 and on 52 individual cardiac surgeons who performed at least 100 bypass operations in one hospital in 2002-2003.  Jersey City Medical Center, which was licensed for cardiac surgery in November 2004, will be included in future reports.

New Jersey is one of three states to examine 30-day mortality rates for patients undergoing coronary artery bypass graft surgery.  Thirty-day mortality includes deaths during the cardiac surgery hospitalization, as well as deaths after discharge but within 30 days of surgery, whichever comes later.

According to the most recent data available, hospitals performed 6,817 isolated bypass surgeries in 2003, and 159 patients died in the hospital or within 30 days, resulting in a 2.33 percent mortality rate.  When compared on a risk-adjusted basis, this is not significantly different from the 2002 rate of 2.15. 

Rates for individual hospitals and surgeons are risk-adjusted to allow fair comparisons.  In effect, risk-adjustment gives “extra credit” to hospitals and physicians treating sicker patients.  Previous heart surgery, kidney failure, and lung disease were some of the conditions considered in adjusting the data.

According to the report, Hackensack University Medical Center had a risk-adjusted mortality rate that was significantly lower than the statewide average.  Cooper Hospital/University Medical Center’s rate was significantly higher than the average.  The remaining 15 hospitals had rates statistically the same as the statewide average.

Englewood Hospital and Medical Center had no deaths in 2003, but the risk-adjusted mortality rate was not significantly different from the statewide average.

“With the statewide average mortality rate so low, it is very good news for consumers that nearly all of our hospitals are performing at the average or better,” Dr. Jacobs explained.

 The department previously required that external experts thoroughly review Cooper Hospital’s cardiac surgery program.  Results of the review, and the hospital’s plan for improvement were submitted to the department.  DHSS will review the report card data with Cooper, but it may be that the hospital has already addressed issues that led to the 2003 results.

The DHSS report also examined individual surgeon performance for 2002-2003 combined.  No surgeon had a risk-adjusted mortality rate that was significantly lower than the statewide average, although one Englewood Hospital surgeon had no patient deaths during this time period.  One surgeon still practicing in New Jersey -- at Our Lady of Lourdes Medical Center -- had a mortality rate that was significantly higher than the statewide average.

In 2003, the number of bypass surgeries performed ranged from a low of 118 at Englewood Hospital to a high of 857 at Morristown Memorial Hospital, with an average of 351.  The report notes that cardiac surgery volume has declined 15 percent from 2000 to 2004 as patients are increasingly being treated with angioplasty, a less invasive procedure that can often substitute for bypass surgery.

 To examine trends in statewide performance over the last decade, DHSS analyzed ten years of data and risk-adjusted them to account for changes in the patient population.  That showed that the death rate has dropped by 50 percent – from 4.5 percent in 1994 to 2.27 in 2003 on a risk-adjusted basis.

 Four other states report on cardiac surgery outcomes.  Pennsylvania and Massachusetts examine 30-day mortality, while New York and California look at in-hospital deaths.

The web version of the consumer report is available on the DHSS web site at www.state.nj.us/health/hcsa/cs.html.  Reports may also be obtained by calling 1-800-418-1397, or by writing to the New Jersey Department of Health and Senior Services, Office of health Care Quality Assessment, P.O. Box 360, Trenton, NJ 08625.