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Report: WB General had higher than expected mortality rates for 3 conditions

Times Leader - 11/16/2018

Nov. 16--Wilkes-Barre General Hospital had higher than expected mortality rates in treating three conditions -- abnormal heartbeat, acute kidney failure and sepsis -- according to a new report released Thursday. But it had lower than expected readmission rates for kidney and urinary tract infections.

Meanwhile, Geisinger Wyoming Valley had better than expected mortality rates for Chronic Obstructive Pulmonary Disease (COPD), respiratory failure and sepsis. But Geisinger Medical Center in Danville did not fare as well, with worse than expected mortality rates for kidney and urinary tract infections, pneumonia-aspiration and respiratory failure.

The data was publicized in the annual "Hospital Performance Report" compiled by the Pennsylvania Health Care Cost Containment Council, an independent state agency tasked with analyzing data to improve the quality of care and restrain cost increases. This report looked at results for those 18 and over discharged from hospitals from October 2016 through September 2017. It looked at 16 medical conditions or procedures.

Wilkes-Barre General spokeswoman Renita Fennick issued an email statement noting "our current internal data indicates that our mortality rates for patients admitted for abnormal heartbeat and acute kidney failure are not higher than expected," suggesting this is due to "continuing efforts to strengthen our clinical outcomes." She also noted many patients admitted for sepsis "have been transferred here from nursing homes or are terminally ill individuals who suffer from several complications," and that sepsis mortality is on the rise nationwide.

In a written response, Geisinger Chief Quality Officer Dr. Neil Martin said Geisinger Medical Center is a Level One trauma center serving as "the hospital of last resort for the sickest patients from a large region of Pennsylvania." He noted the hospital has an open-door policy, accepting "patients regardless of anticipated poor outcomes."

Martin said the report does not reflect recent efforts, including a "new protocol for the treatment of patients with life-threatening sepsis that has reduced the mortality rate dramatically over the past six months."

Geisinger Wyoming Valley Chief Medical Officer Dr. Karlyn Paglia commented specifically about the Luzerne County facility, supporting the work of the council. "We also value the trust our patients place in us when they are at their most vulnerable. Our highly-trained staff excels in recognizing and treating diseases that affect our community."

Decreasing rates

Statewide, the report notes, mortality rates "showed a statistically significant decrease from 2012 to 2017" in nine conditions, with the biggest decrease in respiratory failure. The mortality rate dropped from 15.2 percent to 8.9 percent in that five-year period.

Other conditions seeing a statistically significant drop in mortality rates from 2012 to 2017 were sepsis (13.8 percent to 9.3 percent), heart attack-medical management (9 percent to 7.6 percent), pneumonia-aspiration (6.4 percent to 5.2 percent), acute kidney failure (3.4 percent to 2.4 percent), stroke (3.9 percent to 3 percent), infectious pneumonia (2.4 percent to 1.8 percent), colorectal procedures (2.1 percent to 1.6 percent) and heart failure (2.8 percent to 2.4 percent).

None of the conditions analyzed saw a significant increase in mortality rates across the state.

The report also breaks the state into three regions: southeastern, western and central/northeastern. The last one covers 30 counties, including Luzerne and Lackawanna. It saw statistically significant decreases in six conditions: respiratory failure, sepsis, heart attack-medical management, acute kidney failure, heart failure and infectious pneumonia.

Of the three regions, Southeastern Pennsylvania may be the place to check into a hospital. In 2017, mortality rates were lower than expected for 11 conditions, while no condition had a mortality rate higher than expected.

In contrast, the central/northeastern region and the western region had no conditions where mortality was lower than expected, but had conditions where it was higher than expected.

Of the two, our region fared considerably better than the west, with higher than expected mortality rates in four conditions: abnormal heartbeat, acute kidney failure, sepsis and stroke. By comparison, western Pennsylvania had higher than expected mortality rates for nine conditions.

Reach Mark Guydish at 570-991-6112 or on Twitter @TLMarkGuydish

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