OBJECTIVES

: Failure to rescue (FTR), which estimates the probability of death after a complication in operation, is often used as a measure of care quality. The objective of this study was to identify risk factors associated with FTR in patients with Acute Myocardial Infarction (AMI).

METHODS

: We used inpatient data from the Texas Department of State Health Services between 2011 to 2014. We used ICD-9-CM codes to identify 8 major postoperative complications including: pulmonary failure, pneumonia, myocardial infarction, deep venous thrombosis/pulmonary embolism, acute renal failure, hemorrhage, surgical site infection, and gastrointestinal bleeding. Then, we estimated the FTR rate by dividing the number of deaths for all patients by the number of patients with complications plus the number of patients who died without a complication. We identified 165, 988 records of AMI patients with 8,961 incidences of FTR over the four years of study. We used logit regression and regressed FTR on the pool of variables, including race, age, sex, ethnicity, rurality, type of admission, and illness severity for the AMI group.

RESULTS

: Our primary outcomes showed that the odds of FTR was lower for all Black and White individuals (p<0.000) compared with the Native Americans. We further found that the odds of FTR has increased as age increased. Our finding also showed that odds of FTR was higher for women (p<0.000), individuals with Hispanic origins (p<0.000) and rural areas (p<0.000). We also found that odds of FTR was higher for the urgent (p<0.000) and trauma (p<0.000) admissions, and lower for the elective (p<0.000) admissions compared with the emergency admissions. Moreover, we found that the odds of FTR increases as illness severity increased.

CONCLUSIONS

: While race, age, sex, ethnicity, rurality, type of admission, and illness severity are the significant predictors of FTR , further research is required to know how these factors affect survival after complications.