BACKGROUND: We evaluated outcomes for common operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSDB) to provide contemporary benchmarks and examine variation between centers. METHODS: Patients undergoing surgery from 2005 to 2009 were included. Centers with greater than 10% missing data were excluded. Discharge mortality and postoperative length of stay (PLOS) among patients discharged alive were calculated for 8 benchmark operations of varying complexity. Power for analyzing between-center variation in outcome was determined for each operation. Variation was evaluated using funnel plots and Bayesian hierarchical modeling. RESULTS: Eighteen thousand three hundred seventy-five index operations at 74 centers were included in the analysis of 8 benchmark operations. Overall discharge mortality was: ventricular septal defect (VSD) repair = 0.6% (range, 0% to 5.1%), tetralogy of Fallot (TOF) repair = 1.1% (range, 0% to 16.7%), complete atrioventricular canal repair (AVC) = 2.2% (range, 0% to 20%), arterial switch operation (ASO) = 2.9% (range, 0% to 50%), ASO + VSD = 7.0% (range, 0% to 100%), Fontan operation = 1.3% (range, 0% to 9.1%), truncus arteriosus repair = 10.9% (0% to 100%), and Norwood procedure = 19.3% (range, 0% to 100%). Funnel plots revealed that the number of centers characterized as outliers were VSD = 0, TOF = 0, AVC = 1, ASO = 3, ASO + VSD = 1, Fontan operation = 0, truncus arteriosus repair = 4, and Norwood procedure = 11. Power calculations showed that statistically meaningful comparisons of mortality rates between centers could be made only for the Norwood procedure, for which the Bayesian-estimated range (95% probability interval) after risk-adjustment was 7.0% (3.7% to 10.3%) to 41.6% (30.6% to 57.2%). Between-center variation in PLOS was analyzed for all operations and was larger for more complex operations. CONCLUSIONS: This analysis documents contemporary benchmarks for common pediatric cardiac surgical operations and the range of outcomes among centers. Variation was most prominent for the more complex operations. These data may aid in quality assessment and quality improvement initiatives.
BACKGROUND: We evaluated outcomes for common operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSDB) to provide contemporary benchmarks and examine variation between centers. METHODS:Patients undergoing surgery from 2005 to 2009 were included. Centers with greater than 10% missing data were excluded. Discharge mortality and postoperative length of stay (PLOS) among patients discharged alive were calculated for 8 benchmark operations of varying complexity. Power for analyzing between-center variation in outcome was determined for each operation. Variation was evaluated using funnel plots and Bayesian hierarchical modeling. RESULTS: Eighteen thousand three hundred seventy-five index operations at 74 centers were included in the analysis of 8 benchmark operations. Overall discharge mortality was: ventricular septal defect (VSD) repair = 0.6% (range, 0% to 5.1%), tetralogy of Fallot (TOF) repair = 1.1% (range, 0% to 16.7%), complete atrioventricular canal repair (AVC) = 2.2% (range, 0% to 20%), arterial switch operation (ASO) = 2.9% (range, 0% to 50%), ASO + VSD = 7.0% (range, 0% to 100%), Fontan operation = 1.3% (range, 0% to 9.1%), truncus arteriosus repair = 10.9% (0% to 100%), and Norwood procedure = 19.3% (range, 0% to 100%). Funnel plots revealed that the number of centers characterized as outliers were VSD = 0, TOF = 0, AVC = 1, ASO = 3, ASO + VSD = 1, Fontan operation = 0, truncus arteriosus repair = 4, and Norwood procedure = 11. Power calculations showed that statistically meaningful comparisons of mortality rates between centers could be made only for the Norwood procedure, for which the Bayesian-estimated range (95% probability interval) after risk-adjustment was 7.0% (3.7% to 10.3%) to 41.6% (30.6% to 57.2%). Between-center variation in PLOS was analyzed for all operations and was larger for more complex operations. CONCLUSIONS: This analysis documents contemporary benchmarks for common pediatric cardiac surgical operations and the range of outcomes among centers. Variation was most prominent for the more complex operations. These data may aid in quality assessment and quality improvement initiatives.
Authors: Jeffrey Phillip Jacobs; Constantine Mavroudis; Marshall Lewis Jacobs; Bohdan Maruszewski; Christo I Tchervenkov; François G Lacour-Gayet; David Robinson Clarke; Thomas Yeh; Henry L Walters; Hiromi Kurosawa; Giovanni Stellin; Tjark Ebels; Martin J Elliott Journal: Ann Thorac Surg Date: 2006-05 Impact factor: 4.330
Authors: Sean M O'Brien; Jeffrey P Jacobs; David R Clarke; Bohdan Maruszewski; Marshall L Jacobs; Henry L Walters; Christo I Tchervenkov; Karl F Welke; Zdzislaw Tobota; Giovanni Stellin; Constantine Mavroudis; J R Leslie Hamilton; J William Gaynor; Marco Pozzi; Francois G Lacour-Gayet Journal: Ann Thorac Surg Date: 2007-12 Impact factor: 4.330
Authors: Rachel S Dokholyan; Lawrence H Muhlbaier; John M Falletta; Jeffrey P Jacobs; David Shahian; Constance K Haan; Eric D Peterson Journal: Am Heart J Date: 2009-06 Impact factor: 4.749
Authors: J F Stark; S Gallivan; K Davis; J R Hamilton; J L Monro; J C Pollock; K G Watterson Journal: Ann Thorac Surg Date: 2001-07 Impact factor: 4.330
Authors: Jeffrey Phillip Jacobs; Bohdan Maruszewski; Hiromi Kurosawa; Marshall Lewis Jacobs; Constantine Mavroudis; Francois G Lacour-Gayet; Christo I Tchervenkov; Hal Walters; Giovanni Stellin; Tjark Ebels; Victor T Tsang; Martin J Elliott; Arata Murakami; Shunji Sano; John E Mayer; Fred H Edwards; James Anthony Quintessenza Journal: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Date: 2010
Authors: Sean M O'Brien; David R Clarke; Jeffrey P Jacobs; Marshall L Jacobs; Francois G Lacour-Gayet; Christian Pizarro; Karl F Welke; Bohdan Maruszewski; Zdzislaw Tobota; Weldon J Miller; Leslie Hamilton; Eric D Peterson; Constantine Mavroudis; Fred H Edwards Journal: J Thorac Cardiovasc Surg Date: 2009-11 Impact factor: 5.209
Authors: Marshall Lewis Jacobs; Jeffrey Phillip Jacobs; Rodney C G Franklin; Constantine Mavroudis; Francois Lacour-Gayet; Christo I Tchervenkov; Hal Walters; Emile A Bacha; David Robinson Clarke; J William Gaynor; Thomas L Spray; Giovanni Stellin; Tjark Ebels; Bohdan Maruszewski; Zdzislaw Tobota; Hiromi Kurosawa; Martin Elliott Journal: Cardiol Young Date: 2008-12 Impact factor: 1.093
Authors: Jeffrey Phillip Jacobs; Marshall Lewis Jacobs; Bohdan Maruszewski; Francois G Lacour-Gayet; Christo I Tchervenkov; Zdzislaw Tobota; Giovanni Stellin; Hiromi Kurosawa; Arata Murakami; J William Gaynor; Sara K Pasquali; David R Clarke; Erle H Austin; Constantine Mavroudis Journal: Eur J Cardiothorac Surg Date: 2012-06-14 Impact factor: 4.191
Authors: Katherine E Bates; Nicolas L Madsen; Lara Khadr; Zhiqian Gao; Kari Crawford; Michael Gaies; Margaret Graupe; Samuel P Hanke; Anthony M Hlavacek; Evonne Morell; Sara K Pasquali; Jennifer L Russell; Susan K Schachtner; Ronn E Tanel; Adam L Ware; Alaina K Kipps Journal: Ann Thorac Surg Date: 2019-11-21 Impact factor: 4.330
Authors: Logan G Spector; Jeremiah S Menk; Jessica H Knight; Courtney McCracken; Amanda S Thomas; Jeffrey M Vinocur; Matthew E Oster; James D St Louis; James H Moller; Lazaros Kochilas Journal: J Am Coll Cardiol Date: 2018-05-29 Impact factor: 24.094
Authors: David W Jantzen; Xia He; Jeffrey P Jacobs; Marshall L Jacobs; Michael G Gaies; Matt Hall; John E Mayer; Samir S Shah; Jennifer Hirsch-Romano; J William Gaynor; Eric D Peterson; Sara K Pasquali Journal: World J Pediatr Congenit Heart Surg Date: 2014-07
Authors: Jeffrey Phillip Jacobs; Sean M O'Brien; Sara K Pasquali; Sunghee Kim; J William Gaynor; Christo Ivanov Tchervenkov; Tara Karamlou; Karl F Welke; Francois Lacour-Gayet; Constantine Mavroudis; John E Mayer; Richard A Jonas; Fred H Edwards; Frederick L Grover; David M Shahian; Marshall Lewis Jacobs Journal: Ann Thorac Surg Date: 2014-09-26 Impact factor: 4.330
Authors: Sara K Pasquali; Marshall L Jacobs; Xia He; Samir S Shah; Eric D Peterson; Matthew Hall; J William Gaynor; Kevin D Hill; John E Mayer; Jeffrey P Jacobs; Jennifer S Li Journal: Pediatrics Date: 2014-02-24 Impact factor: 7.124
Authors: Dean B Andropoulos; Hasan B Ahmad; Taha Haq; Ken Brady; Stephen A Stayer; Marcie R Meador; Jill V Hunter; Carlos Rivera; Robert G Voigt; Marie Turcich; Cathy Q He; Lara S Shekerdemian; Heather A Dickerson; Charles D Fraser; E Dean McKenzie; Jeffrey S Heinle; R Blaine Easley Journal: Paediatr Anaesth Date: 2014-03 Impact factor: 2.556
Authors: Sara K Pasquali; Amelia S Wallace; J William Gaynor; Marshall L Jacobs; Sean M O'Brien; Kevin D Hill; Michael G Gaies; Jennifer C Romano; David M Shahian; John E Mayer; Jeffrey P Jacobs Journal: Ann Thorac Surg Date: 2016-07-22 Impact factor: 4.330