PUBLISHED: | UPDATED:

CHICO — In the state”s latest report card on heart-bypass surgery, Enloe Medical Center got a passing grade for its mortality rate but a low mark for not using a recommended procedure often enough.

Laura Hennum, an Enloe vice president, said hospital officials were very pleased with the mortality grade.

On the other issue, the use of a certain kind of artery, the hospital is making progress, said Pablo Zubiate, cardiovascular surgical coordinator for Enloe”s heart program.

The report, which came out this week, looked at the death rate for heart-bypass surgeries done at 122 California hospitals during 2008 (the latest data available to the state).

It said 13,957 “isolated” operations were performed that year where the surgeries” purpose was only to bypass blocked arteries leading to the heart. Of the 13,957 patients, 313 died (2.24 percent).

At Enloe in 2008, 134 isolated bypass operations were done, and two patients died (1.49 percent).

In the report, hospitals were categorized by region, and the cases were “risk adjusted” so hospital performances could be validly compared, theoretically. “Risk adjusted” means cases were rated according to the severity of patients” heart problems and the condition of their health.

The hospitals were categorized by region. In the Sacramento and Northern California Region, Enloe was listed among nine hospitals that performed heart-bypass surgery.

Enloe”s risk-adjusted mortality rate for 2008 was 1.35 percent.

Five hospitals in the region had better risk-adjusted rates than Enloe”s. They were St. Joseph Hospital in Eureka, 0.00 percent; Sutter Memorial Hospital in Sacramento, 0.64; Mercy General Hospital in Sacramento, 0.89; UC Davis Medical Center in Sacramento, 0.93; and Mercy San Juan Hospital in Carmichael, 0.96 percent.

Three hospitals had risk-adjusted death rates that were worse than Enloe”s. They were Mercy Medical Center in Redding, 2.20 percent; Rideout Memorial Hospital in Marysville, 4.39 percent; and Shasta Regional Medical Center in Redding, 5.41 percent.

The report also evaluated the 122 hospitals according to how often patients had strokes after heart-bypass surgery. In the state, where 28,711 patients had isolated bypass surgery in 2007 and 2008, 411 patients had strokes after their operations.

Of the nine hospitals in the Northern California region, Enloe had the second lowest risk-adjusted rate for post-operative strokes: 0.67 percent. Only St. Joseph Hospital in Eureka was lower, with a rate of 0.00. The hospital with the highest rate in the region was Mercy General Hospital at 2.20 percent.

The report also went into hospitals” use of the internal mammary artery in bypass surgery.

Two of these arteries are connected to the rib cage inside the chest cavity, said Joseph Parker, manager of the Healthcare Outcomes Center at the Office of Statewide Healthcare Planning and Development, which issued the report.

In bypass surgery, blood vessels have to be taken from the patient”s body and attached to the blocked coronary arteries to create bypasses. Parker said many studies show that when feasible, the internal mammary artery is the best choice because it stays open longer than other arteries, and patients live longer.

According to the report, Enloe was one of five hospitals rated “low” for frequency of using the internal mammary artery. It was the only hospital in Northern California to get such a rating.

During 2008, in 118 operations, Enloe used the artery 82.2 percent of the time. The state average was 95.9 percent, Parker said.

Enloe is working on increasing its use of the mammary artery, Zubiate said . Its use is not always appropriate, such as when a patient is severely ill. Sometimes it”s not feasible in elderly patients.

In data for 2010, submitted to the Society of Thoracic Surgeons, Enloe”s use of the mammary artery was at 89.2 percent, he said.

The report also evaluated the surgeons who did bypass surgery. The two surgeons who worked at Enloe during 2007 and 2008, Dr. Li Poa and Dr. Miguel Puig-Palomar, got passing marks as did almost all heart surgeons in the state.

The report said Poa did 61 isolated bypass surgeries in those two years. Of those patients, four died (6.56 percent). His risk-adjusted mortality rate was 5.59 percent.

Puig-Palomar performed 220 isolated bypass surgeries. Of those patients, nine died (4.09 percent). His risk-adjusted mortality rate was listed as 3.86 percent.

Staff writer Larry Mitchell can be reached at 896-7759 or lmitchell@chicoer.com.

blog comments powered by Disqus