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Clinical Outcomes at Fortis Healthcare

Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from patient care. Reporting of outcomes and their continuous monitoring provides an opportunity for both assessing and improving the quality of patient health and care.

Fortis Healthcare Limited, one of the largest integrated, healthcare service provider in the country is the first hospital network to implement and monitor clinical outcomes in India. This initiative further strengthens our commitment to PATIENT CENTRICITY by striving towards continuous clinical excellence through improvement and enhancement of our clinical care services. Further, the introduction of Patient-Reported Outcomes Measurement [PROM] lends the voice of the patient to the entire process and helps enhance patient engagement and experience. Constant evaluation of our clinical outcomes against best available global standards motivates our medical workforce to continuously improve all aspects of our practice.

Fortis clinical outcomes are based on measurement of disease course and progression, quality of clinical care being provided, the success of the procedures/interventions carried out, and actual benefit perceived by the patient.

Details of individual procedure outcomes as measured using internationally accepted parameters and criteria, and further validated by our clinical experts, are published here and showcase our commitment to transparency in healthcare. Fortis is the FIRST to embark on the journey of publishing clinical outcomes data in the public realm.

 

We at Fortis continuously monitor and evaluate our outcomes for the following procedures and specialities

 

Coronary Artery Bypass Graft (CABG)

ABOUT THE PROCEDURE

Coronary Artery Bypass Graft (CABG), commonly known as Heart Bypass surgery/ Coronary Bypass surgery, is a surgical procedure which creates alternate routes for blood to flow to the heart tissue, bypassing the narrowed/blocked arteries (leading to what is known as Coronary Artery Disease). For this purpose, a healthy blood vessel (also called a graft) taken from one area of patient’s own body is placed around the narrowed/blocked area to restore blood flow to the heart. The goal of this procedure is to relieve symptoms of coronary artery disease (including angina), enable the patient to resume a normal lifestyle and to lower the risk of a heart attack or other heart problems.

ABOUT CABG CLINICAL OUTCOMES

CABG outcome indicators provide measures of overall success of the surgery and patient’s post-procedure clinical condition. These parameters are globally accepted evidence-based scientific criteria to indicate quality of procedure and patient’s health status. Fortis hospitals measure the following outcomes parameters for CABG, and our performance consistently matches the global benchmarks set by best-in-class hospitals.

CORONARY ARTERY BYPASS GRAFT (CABG) - Fortis Healthcare#
Parameter202320222019201820172016Benchmark
Use of left Internal Thoracic Artery graft86.36%85.81%84.83%84.58%85.03%81.36%74.20% *
Need for Bail out Intra Aortic Balloon Pump (IABP)0.98%1.87%2.27%2.47%1.77%2.73%--
Perioperative Myocardial Infarction0.07%0.37%0.33%0.24%0.28%0.19%0.96% **
Post procedure neurological stroke0.20%0.33%0.36%0.13%0.17%0.19%0.80% *
Need of Re-exploration surgery2.02%1.91%1.21%1.20%1.55%1.62%3.50% *
Deep sternal wound infection0%0.20%0.42%0.58%0.78%0.88%0.20% *
Predicted mortality2.71%2.42%3.00%3.03%2.52%2.61%--
Mortality during same hospital admission1.77%1.77%2.24%1.89%1.66%2.24%--

 

µ Non risk adjusted

# Includes clinical outcome from those Fortis hospitals whose data is published on FHL website; doesn't represent all Fortis hospitals across India  
Outcomes data of 2020 & 2021 not published due to impact of COVID pandemic

References:  
¶ STS Annual Report 2019  
* Cleveland Clinic Outcomes Report 2014  
** Texas Heart Institute 2014

Percutaneous Transluminal Coronary Angioplasty (PTCA)

ABOUT THE PROCEDURE

Percutaneous coronary intervention (PCI/PTCA), also known as coronary angioplasty, is a nonsurgical technique for treating narrowed/blocked coronary arteries which supply blood to the heart muscle. PTCA involves inserting a tiny balloon or stent across the narrowed part to widen the affected artery and restore blood flow to the heart muscle without requiring an open-heart surgery.

ABOUT PTCA CLINICAL OUTCOMES

PTCA outcome indicators provide measures of overall success of the surgery and patient’s post-procedure clinical condition. These parameters are globally accepted evidence-based scientific criteria to indicate quality of procedure and patient’s health status. Fortis hospitals measure the following outcomes parameters for PTCA, and our performance consistently matches the global benchmarks set by best-in-class hospitals.

PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA) - Fortis Healthcare#
Parameter202320222019201820172016Benchmark
Emergency CABG for failed procedure0.04%0.04%0.06%0.02%0.00%0.06%1.2% *
Vascular complication at puncture site requiring intervention0.04%0.05%0.02%0.03%0.11%0.09%1.1% *
Acute vessel occlusion requiring emergency re-intervention0.23%0.12%0.09%0.16%0.03%0.06%--
Post procedure neurological stroke0.12%0.04%0.04%0.05%0.00%0.06%0.284 % **
Post procedure Renal failure requiring hemodialysis0.13%0.35%0.23%0.30%0.08%0.13%--
Any Bleeding event requiring transfusion/intervention (within 72 hrs.)0.17%0.30%0.27%0.20%0.22%0.32%4.0 % *
Delayed vascular complication at puncture site0.02%0.01%0.12%0.04%0.03%0.04%--
Readmission with acute Myocardial Infarction within 30 days0.06%0.08%0.22%0.21%0.19%0.15%--
Mortality during same hospital admission1.81%1.98%1.70%1.57%1.40%1.71%1.7 % *

 

# Includes clinical outcome from those Fortis hospitals whose data is published on FHL website; doesn't represent all Fortis hospitals across India  
Outcomes data of 2020 & 2021 not published due to impact of COVID pandemic

References:  
*US National Registry Data 2013  
**Cleveland Clinic Outcomes Report 2014

Kidney Transplant

ABOUT THE PROCEDURE

Kidney transplantation means replacement of the failed kidney with a healthy kidney from another person, called a donor, living or deceased. When kidneys fail to filter fluid and wastes, these may accumulate in the body to the harmful level. When the kidneys have lost about 90 percent of their normal functioning ability, patients have kidney failure (or End-stage Renal Disease) and require either dialysis or transplantation to sustain their life. Kidney transplant provides significant quality-of-life benefits and survival in patients with end-stage kidney disease/Kidney failure/ in this condition.

ABOUT KTP CLINICAL OUTCOME

Monitoring of patient survival over longer and defined periods is regarded as successful outcomes of kidney transplant procedure. Acute rejection within the first-year post-transplantation is a negative predictor of long-term renal allograft survival.

Kidney Transplant -  Fortis Healthcare#
One year survival rate of Kidney Transplant patientsApr’ 2021 - Mar’ 2022Apr’ 2020 - Mar’ 2021Apr’ 2018 - Mar’ 2019Apr’ 2017 - Mar’ 2018Apr’ 2016 - Mar’ 2017Apr’ 2015 - Mar’ 2016Benchmark
One year survival95.4%94.81%94.81%96.26%97.18%96.39%90-95% *  
90-95% **  
97% ***

 

# Includes clinical outcome from those Fortis hospitals whose data is published on FHL website; doesn't represent all Fortis hospitals across India

References:  
* Kidney Research UK  
** Kidney Foundation of Canada  
*** National Kidney Foundation, USA  
 

Radiation Oncology

ABOUT THE PROCEDURE

Radiation is one of the most common treatments for cancer, and is utilised for more than 60% of cancer therapy. It uses carefully measured and optimally controlled high-energy particles or waves, such as x-rays, gamma rays, electron beams or protons aimed to destroy cancer cells in body. This therapy can also be combined with other treatment options like chemotherapy and surgery. The goal is to use this as primary curative treatment for cancer or adjuvant therapy or to prevent recurrence of tumour and improve a person’s quality of life.

Sometimes in advanced or late-stage of a cancer, it is not possible to destroy all of the tumour cells, then doctors may use palliative radiation therapy to shrink tumours and relieve/reduce pain, pressure and other symptoms.

ABOUT OUTCOMES

Every person reacts differently to treatment. Acute radiation toxicities are side effects that may occur during treatment or in the immediate post-treatment period, depending on the type of cancer, location, dose and length of radiation and patient’s general health. Onset may be 2–3 weeks after the commencement of a regimen of radiation therapy. Typically, severity and timing are tied to the total biologic dose and the turnover rate of the tissue in question, respectively.

Radiation Oncology -  Fortis Healthcare#
Radation Oncology2023Benchmark
Treatment Completion100%--
Treatment - Curative73.4%--
Treatment - Palliative26.6%--
Acute morbidity post Radiotheraphy (Grade 3 and 4)0%5 - 5%

 

# Includes clinical outcome from those Fortis hospitals whose data is published on FHL website; doesn't represent all Fortis hospitals across India

References: Radiation Therapy Oncology Group (RTOG) common toxicity criteria (CTC) v.2.0        
Toxicity severity grading:-        
Grade 3—Severe and undesirable;        
Grade 4—Life-threatening or disabling;        
Grade 5—Death 

 

Endoscopic Retrograde Cholangio Pancreatography (ERCP)

ABOUT THE PROCEDURE

Endoscopic Retrograde Cholangiopancreatography, also known as ERCP, is a minimally invasive procedure that combines use of X-ray and an endoscope. This procedure is used to diagnose and treat problems of the upper Gastrointestinal Tract and related organs like Liver, Gall Bladder, Bile ducts and Pancreas. It uses a thin, long, flexible, lighted tube called endoscope which is inserted through the mouth and down the throat into the small intestine and a dye (contrast material) is then injected to highlight these organs under X-ray. The procedure is used to detect a block and identify probable cause, or infection in a bile duct or pancreatic duct; and to collect samples of cells or tissue (called a biopsy). Sometimes a stent may be placed through the scope to relieve any blockage in these ducts to allow passage of bile or pancreatic juice onto the intestine.

ABOUT OUTCOMES

A commonly performed endoscopic procedure, ERCP is usually safe and well-tolerated, though success of the procedure may vary depending upon various patient and care related factors like age, gender, presence of anatomical variants, previous upper abdominal surgery, the success of the cannulation, technique etc. A higher success rate of biliary cannulation leads to better outcome and lower complications.

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) - Fortis Healthcare#
Parameter20232022201920182017
Successful CBD cannulation94.4%94.10%92.05%94.23%97.32%
Successful extraction84.6%76.80%89.18%92.77%92.55%
Intended outcome achieved95.4%95.71%90.07%94.23%94.23%
Major Post procedure complication2.25%3.28%0.44%1.03%1.44%
In-hospital mortality0.06%0.07%0.00%0.62%0.21%

 

# Includes clinical outcome from those Fortis hospitals whose data is published on FHL website; doesn't represent all Fortis hospitals across India  
Outcomes data of 2020 & 2021 not published due to impact of COVID pandemic

Clinical outcomes of following procedures and specialities are also monitored and shall be published

  1. Mental Health
  2. Caesarean Section
  3. Hysterectomy
  4. Liver Transplant
  5. Total Knee Replacement
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