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Risk-adjustment model in health outcomes evaluation: a contribution to strengthen assessment towards quality improvement in interventional cardiology

dc.contributor.authorSousa, P.
dc.contributor.authorUva, A. S.
dc.contributor.authorPinto, Fausto J.
dc.date.accessioned2018-11-14T17:14:12Z
dc.date.available2018-11-14T17:14:12Z
dc.date.issued2008
dc.description© The Author 2008. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.pt_PT
dc.description.abstractObjective: The aim of this study was to develop a risk adjustment model for major adverse cardiac and cerebrovascular events following percutaneous coronary intervention (PCI), using data from a national registry, and to highlight the use of the risk adjustment when we evaluate the quality of care in interventional cardiology. Design: The study design was based on a Coorte study. Bivariate and multivariate logistic regression models were used to identify independent risk factors for these major adverse events. Setting: A total of 19 hospitals from the Portuguese National Registry of Interventional Cardiology. Participants: Data from 10.641 consecutives procedures collected between June 30, 2003 and June 30, 2006. Intervention: Build a risk adjustment model for these major adverse events, following percutaneous coronary intervention. Main Outcome Measure: Factors that were associated with major adverse cardiac and cerebrovascular events following percutaneous coronary intervention. Results: The rate of in-hospital major adverse cardiac and cerebrovascular events was 1.9%. Factors associated with major adverse cardiac and cerebrovascular events included, among others: age >80 years (adjusted odds ratio = 3.91); female gender (1.72); and cardiogenic shock (6.05). Overall, a good discrimination was achieved with receiver operating characteristics curve = 0.84 and Hosmer-Lemeshow goodness of fit statistic across groups of risk was not significant (P = 0.18) indicating little departure from a perfect fit. Conclusions: These findings will represent an important contribution to quality and safety improvement and should help driving new research and innovative approaches to different subgroups of patients who have higher chances of having an adverse event or poorer outcomes following this intervention.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInternational Journal for Quality in Health Care, Volume 20, Issue 5, 1 October 2008, pp. 324–330pt_PT
dc.identifier.doi10.1093/intqhc/mzn029pt_PT
dc.identifier.issn1353-4505
dc.identifier.urihttp://hdl.handle.net/10451/35328
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation.publisherversionhttps://academic.oup.com/intqhcpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectRisk adjustmentpt_PT
dc.subjectPCIpt_PT
dc.subjectQuality improvementpt_PT
dc.subjectSafetypt_PT
dc.subjectOutcomes researchpt_PT
dc.titleRisk-adjustment model in health outcomes evaluation: a contribution to strengthen assessment towards quality improvement in interventional cardiologypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage330pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage324pt_PT
oaire.citation.titleInternational Journal for Quality in Health Carept_PT
oaire.citation.volume20pt_PT
person.familyNamePinto
person.givenNameFausto J.
person.identifier1308889
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.orcid0000-0002-8034-4529
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id7102740158
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5f44176f-69f5-482c-83cd-ab94425a6ec3
relation.isAuthorOfPublication.latestForDiscovery5f44176f-69f5-482c-83cd-ab94425a6ec3

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