Literature DB >> 22704799

Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the STS Congenital Heart Surgery Database.

Jeffrey Phillip Jacobs1, Sean M O'Brien, Sara K Pasquali, Marshall Lewis Jacobs, François G Lacour-Gayet, Christo I Tchervenkov, Erle H Austin, Christian Pizarro, Kamal K Pourmoghadam, Frank G Scholl, Karl F Welke, J William Gaynor, David R Clarke, John E Mayer, Constantine Mavroudis.   

Abstract

BACKGROUND: We evaluated outcomes for groups of risk-stratified operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database to provide contemporary benchmarks and examine variation between centers.
METHODS: Patients undergoing surgery from 2005 to 2009 were included. Centers with more than 10% missing data were excluded. Discharge mortality and postoperative length of stay (PLOS) among patients discharged alive were calculated for groups of risk-stratified operations using the five Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery mortality categories (STAT Mortality Categories). Power for analyzing between-center differences in outcome was determined for each STAT Mortality Category. Variation was evaluated using funnel plots and Bayesian hierarchical modeling.
RESULTS: In this analysis of risk-stratified operations, 58,506 index operations at 73 centers were included. Overall discharge mortality (interquartile range among programs with more than 10 cases) was as follows: STAT Category 1=0.55% (0% to 1.0%), STAT Category 2=1.7% (1.0% to 2.2%), STAT Category 3=2.6% (1.1% to 4.4%), STAT Category 4=8.0% (6.3% to 11.1%), and STAT Category 5=18.4% (13.9% to 27.9%). Funnel plots with 95% prediction limits revealed the number of centers characterized as outliers by STAT Mortality Categories was as follows: Category 1=3 (4.1%), Category 2=1 (1.4%), Category 3=7 (9.7%), Category 4=13 (17.8%), and Category 5=13 (18.6%). Between-center variation in PLOS was analyzed for all STAT Categories and was greatest for STAT Category 5 operations.
CONCLUSIONS: This analysis documents contemporary benchmarks for risk-stratified pediatric cardiac surgical operations grouped by STAT Mortality Categories and the range of outcomes among centers. Variation was greatest for the more complex operations. These data may aid in the design and planning of quality assessment and quality improvement initiatives.
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 22704799      PMCID: PMC4006082          DOI: 10.1016/j.athoracsur.2012.01.105

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


  11 in total

1.  What is operative mortality? Defining death in a surgical registry database: a report of the STS Congenital Database Taskforce and the Joint EACTS-STS Congenital Database Committee.

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

2.  Surgical mortality as an indicator of hospital quality: the problem with small sample size.

Authors:  Justin B Dimick; H Gilbert Welch; John D Birkmeyer
Journal:  JAMA       Date:  2004-08-18       Impact factor: 56.272

3.  Funnel plots for comparing institutional performance.

Authors:  David J Spiegelhalter
Journal:  Stat Med       Date:  2005-04-30       Impact factor: 2.373

4.  Report of the 2005 STS Congenital Heart Surgery Practice and Manpower Survey.

Authors:  Marshall L Jacobs; Constantine Mavroudis; Jeffrey P Jacobs; Christo I Tchervenkov; Glenn J Pelletier
Journal:  Ann Thorac Surg       Date:  2006-09       Impact factor: 4.330

5.  Regulatory and ethical considerations for linking clinical and administrative databases.

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

6.  Quality measures for congenital and pediatric cardiac surgery.

Authors:  Jeffrey Phillip Jacobs; Marshall Lewis Jacobs; Erle H Austin; Constantine Mavroudis; Sara K Pasquali; Francois G Lacour-Gayet; Christo I Tchervenkov; Hal Walters; Emile A Bacha; Pedro J Del Nido; Charles D Fraser; J William Gaynor; Jennifer C Hirsch; David L S Morales; Kamal K Pourmoghadam; James S Tweddell; Richard L Prager; John E Mayer
Journal:  World J Pediatr Congenit Heart Surg       Date:  2012-01-01

7.  Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

Authors:  Jeffrey Phillip Jacobs; Sean M O'Brien; Sara K Pasquali; Marshall Lewis Jacobs; Francois G Lacour-Gayet; Christo I Tchervenkov; Erle H Austin; Christian Pizarro; Kamal K Pourmoghadam; Frank G Scholl; Karl F Welke; Constantine Mavroudis
Journal:  Ann Thorac Surg       Date:  2011-12       Impact factor: 4.330

8.  Congenital heart surgery databases around the world: do we need a global database?

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

9.  An empirically based tool for analyzing mortality associated with congenital heart surgery.

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

Review 10.  Databases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease--the perspective of cardiac surgery.

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

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  28 in total

1.  Center Variation in Chest Tube Duration and Length of Stay After Congenital Heart Surgery.

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

2.  Trends in Long-Term Mortality After Congenital Heart Surgery.

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

3.  The importance of patient-specific preoperative factors: an analysis of the society of thoracic surgeons congenital heart surgery database.

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

4.  Variation in congenital heart surgery costs across hospitals.

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

5.  "Baby Heart Project": the Italian project for accreditation and quality management in pediatric cardiology and cardiac surgery.

Authors:  Sonia B Albanese; Lucio V Zannini; Gianluigi Perri; Giancarlo Crupi; Bruno Turinetto; Giacomo Pongiglione
Journal:  Pediatr Cardiol       Date:  2014-06-01       Impact factor: 1.655

6.  Report from the Society of Thoracic Surgeons National Database Workforce: clarifying the definition of operative mortality.

Authors:  David M Overman; Jeffrey P Jacobs; Richard L Prager; Cameron D Wright; David R Clarke; Sara K Pasquali; Sean M O'Brien; Rachel S Dokholyan; Paul Meehan; Donna E McDonald; Marshall L Jacobs; Constantine Mavroudis; David M Shahian
Journal:  World J Pediatr Congenit Heart Surg       Date:  2013-01

7.  Identified mortality risk factors associated with presentation, initial hospitalisation, and interstage period for the Norwood operation in a multi-centre registry: a report from the national pediatric cardiology-quality improvement collaborative.

Authors:  Russell R Cross; Ashraf S Harahsheh; Robert McCarter; Gerard R Martin
Journal:  Cardiol Young       Date:  2013-02-06       Impact factor: 1.093

8.  Centre variation in cost and outcomes for congenital heart surgery.

Authors:  Sara K Pasquali; Michael G Gaies; Jeffrey P Jacobs; J William Gaynor; Marshall L Jacobs
Journal:  Cardiol Young       Date:  2012-12       Impact factor: 1.093

9.  Hospital variation in postoperative infection and outcome after congenital heart surgery.

Authors:  Sara K Pasquali; Xia He; Marshall L Jacobs; Matthew Hall; J William Gaynor; Samir S Shah; Eric D Peterson; Kevin D Hill; Jennifer S Li; Jeffrey P Jacobs
Journal:  Ann Thorac Surg       Date:  2013-06-28       Impact factor: 4.330

10.  Collaborative quality improvement in the cardiac intensive care unit: development of the Paediatric Cardiac Critical Care Consortium (PC4).

Authors:  Michael Gaies; David S Cooper; Sarah Tabbutt; Steven M Schwartz; Nancy Ghanayem; Nikhil K Chanani; John M Costello; Ravi R Thiagarajan; Peter C Laussen; Lara S Shekerdemian; Janet E Donohue; Gina M Willis; J William Gaynor; Jeffrey P Jacobs; Richard G Ohye; John R Charpie; Sara K Pasquali; Mark A Scheurer
Journal:  Cardiol Young       Date:  2014-08-28       Impact factor: 1.093

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