1.29 for age groups 65–69, 70–74 and ≥ 75; all p < 0.001), among Asians and Native Americans compared with Caucasians (AOR 1.22 and 1.15, p < 0.001); and among patients with hypertension, peripheral vascular disease, diabetes, cerebrovascular disease and congestive heart failure compared to patients without these conditions (AOR > 1.09, all p < 0.001). Variations in indications for surgery were more strongly related to patient mix than to surgeon or hospital effects (intraclass correlation [ICC] = 0.04 for hospital; ICC = 0.01 for surgeon). Conclusion California hospitals and surgeons vary in their distribution of indications for CABG surgery. Further research is required to identify the roles of market factors, referral patterns, patient preferences, and local clinical culture in producing the observed variations."/>
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Table 1 Survival enhancing indications (SEIs) for coronary artery bypass surgeries in California, 2003–2004

From: Survival enhancing indications for coronary artery bypass graft surgery in California

Patient Characteristics N % SEI Status
Left main coronary artery disease (CAD) (Stenosis > 50%) 10,102 25.0 Probable SEIs (N = 33,494, 82.9%)
3-vessel CAD 23,392 57.9  
2-vessel CAD with a diminished LVEF (< 50%) 1,458 3.6 Possible SEIs (N = 3,985, 9.9%)
2-vessel CAD with normal LVEF (=> 50%) but Angina class 3/4 2,527 6.3  
2-vessel CAD with normal LVEF (=> 50%), Angina class 0/1/2 1,441 3.6 Non-SEIs (N = 2,895, 7.2%)
1-vessel CAD 1,402 3.5  
Missing value 52 0.1  
Total 40,374 100.0  
  1. CAD: coronary artery disease; LVEF: left ventricular ejection fraction;
  2. SEIs: survival enhancing indications
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BMC Health Services Research

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