Original Articles: PDF OnlyHospital and Patient Characteristics Associated With Death After Surgery A Study of Adverse Occurrence and Failure to RescueSilber, Jeffrey H. MD, PhD*,†; Williams, Sankey V. MD†,‡; Krakauer, Henry MD, PhD§; Schwartz, Sanford MD†,‡Author Information *From the Department of Pediatrics, The School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania †From the Department of Health Care Systems and the Leonard Davis Institute of Health Economics, The University of Pennsylvania, Philadelphia, Pennsylvania ‡From the Section of General Internal Medicine, The School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania §From the Office of Program Assessment and Information, Health Standards and Quality Bureau, The Health Care Financing Administration, Baltimore, Maryland Medical Care: July 1992 - Volume 30 - Issue 7 - p 615-629 Buy Abstract We asked if the factors that predict overall mortality following two common surgical procedures are different from those that predict adverse occurrences (complications) during the hospitalization or death after an adverse occurrence, which we refer to as “failure to rescue.” We examined 5,972 Medicare patients undergoing elective cholecystectomy or transurethral prostatectomy using three outcome measures: 1) the death rate (number of deaths/number of patients); 2) the adverse occurrence rate (number of patients who developed an adverse occurrence/number of patients); and 3) the failure rate (number of deaths in patients who developed an adverse occurrence/number of patients with an adverse occurrence). The death rate was associated with both hospital and patient characteristics. The adverse occurrence rate was associated primarily with patient characteristics. In contrast, failure to rescue was associated more with hospital characteristics, and was less influenced by patient admission severity of illness as measured by the MedisGroups score. We concluded that factors associated with hospital failure to rescue are different from factors associated with adverse occurrences or death. Understanding the reasons behind variation in mortality rates across hospitals should improve our ability to use mortality statistics to help hospitals upgrade the quality of care. © Lippincott-Raven Publishers.