Jeffrey P Jacobs1, Sean M O'Brien2, Sara K Pasquali3, J William Gaynor4, John E Mayer5, Tara Karamlou6, Karl F Welke7, Giovanni Filardo8, Jane M Han9, Sunghee Kim2, James A Quintessenza10, Christian Pizarro11, Christo I Tchervenkov12, Francois Lacour-Gayet13, Constantine Mavroudis10, Carl L Backer14, Erle H Austin15, Charles D Fraser16, James S Tweddell17, Richard A Jonas18, Fred H Edwards19, Frederick L Grover20, Richard L Prager21, David M Shahian22, Marshall L Jacobs10. 1. Johns Hopkins All Children's Heart Institute, Saint Petersburg, Tampa, and Orlando, Florida; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Florida Hospital for Children, Orlando, Florida. Electronic address: jeffjacobs@msn.com. 2. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. 3. Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan. 4. Division of Cardiothoracic Surgery, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 5. Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. 6. Division of Pediatric Cardiac Surgery, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California. 7. Section of Congenital Cardiovascular Surgery, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois, Peoria, Illinois. 8. Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas. 9. The Society of Thoracic Surgeons, Chicago, Illinois. 10. Johns Hopkins All Children's Heart Institute, Saint Petersburg, Tampa, and Orlando, Florida; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Florida Hospital for Children, Orlando, Florida. 11. Nemours/Alfred I. duPont Hospital, Wilmington, Delaware. 12. McGill University, Montreal Children's Hospital, Montreal, Ontario, Canada. 13. Royal Brompton Hospital, London, United Kingdom. 14. Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 15. Kosair Children's Hospital, University of Louisville, Louisville, Kentucky. 16. Texas Children's Hospital, Baylor College of Medicine, Houston, Texas. 17. Children's Hospital of Wisconsin, Milwaukee, Wisconsin. 18. Children's National Medical Center, Washington D.C. 19. University of Florida, College of Medicine-Jacksonville, Jacksonville, Florida. 20. University of Colorado Denver, School of Medicine, Aurora, Colorado. 21. University of Michigan, Ann Arbor, Michigan. 22. Massachusetts General Hospital Department of Surgery and Center for Quality and Safety, and Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: The empirically derived 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model incorporates adjustment for procedure type and patient-specific factors. The purpose of this report is to describe this model and its application in the assessment of variation in outcomes across centers. METHODS: All index cardiac operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (January 1, 2010, to December 31, 2013) were eligible for inclusion. Isolated patent ductus arteriosus closures in patients weighing less than or equal to 2.5 kg were excluded, as were centers with more than 10% missing data and patients with missing data for key variables. The model includes the following covariates: primary procedure, age, any prior cardiovascular operation, any noncardiac abnormality, any chromosomal abnormality or syndrome, important preoperative factors (mechanical circulatory support, shock persisting at time of operation, mechanical ventilation, renal failure requiring dialysis or renal dysfunction (or both), and neurological deficit), any other preoperative factor, prematurity (neonates and infants), and weight (neonates and infants). Variation across centers was assessed. Centers for which the 95% confidence interval for the observed-to-expected mortality ratio does not include unity are identified as lower-performing or higher-performing programs with respect to operative mortality. RESULTS: Included were 52,224 operations from 86 centers. Overall discharge mortality was 3.7% (1,931 of 52,224). Discharge mortality by age category was neonates, 10.1% (1,129 of 11,144); infants, 3.0% (564 of 18,554), children, 0.9% (167 of 18,407), and adults, 1.7% (71 of 4,119). For all patients, 12 of 86 centers (14%) were lower-performing programs, 67 (78%) were not outliers, and 7 (8%) were higher-performing programs. CONCLUSIONS: The 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model facilitates description of outcomes (mortality) adjusted for procedural and for patient-level factors. Identification of low-performing and high-performing programs may be useful in facilitating quality improvement efforts.
BACKGROUND: The empirically derived 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model incorporates adjustment for procedure type and patient-specific factors. The purpose of this report is to describe this model and its application in the assessment of variation in outcomes across centers. METHODS: All index cardiac operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (January 1, 2010, to December 31, 2013) were eligible for inclusion. Isolated patent ductus arteriosus closures in patients weighing less than or equal to 2.5 kg were excluded, as were centers with more than 10% missing data and patients with missing data for key variables. The model includes the following covariates: primary procedure, age, any prior cardiovascular operation, any noncardiac abnormality, any chromosomal abnormality or syndrome, important preoperative factors (mechanical circulatory support, shock persisting at time of operation, mechanical ventilation, renal failure requiring dialysis or renal dysfunction (or both), and neurological deficit), any other preoperative factor, prematurity (neonates and infants), and weight (neonates and infants). Variation across centers was assessed. Centers for which the 95% confidence interval for the observed-to-expected mortality ratio does not include unity are identified as lower-performing or higher-performing programs with respect to operative mortality. RESULTS: Included were 52,224 operations from 86 centers. Overall discharge mortality was 3.7% (1,931 of 52,224). Discharge mortality by age category was neonates, 10.1% (1,129 of 11,144); infants, 3.0% (564 of 18,554), children, 0.9% (167 of 18,407), and adults, 1.7% (71 of 4,119). For all patients, 12 of 86 centers (14%) were lower-performing programs, 67 (78%) were not outliers, and 7 (8%) were higher-performing programs. CONCLUSIONS: The 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model facilitates description of outcomes (mortality) adjusted for procedural and for patient-level factors. Identification of low-performing and high-performing programs may be useful in facilitating quality improvement efforts.
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: 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: 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
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
Authors: David M Shahian; Fred H Edwards; Jeffrey P Jacobs; Richard L Prager; Sharon-Lise T Normand; Cynthia M Shewan; Sean M O'Brien; Eric D Peterson; Frederick L Grover Journal: Ann Thorac Surg Date: 2011-09 Impact factor: 4.330
Authors: Jeffrey Phillip Jacobs; 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 Journal: Ann Thorac Surg Date: 2012-06-15 Impact factor: 4.330
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 L Jacobs; Sean M O'Brien; Jeffrey P Jacobs; Constantine Mavroudis; Francois Lacour-Gayet; Sara K Pasquali; Karl Welke; Christian Pizarro; Felix Tsai; David R Clarke Journal: J Thorac Cardiovasc Surg Date: 2012-07-24 Impact factor: 5.209
Authors: David R Clarke; Linda S Breen; Marshall L Jacobs; Rodney C G Franklin; Zdzislaw Tobota; Bohdan Maruszewski; Jeffrey P Jacobs Journal: Cardiol Young Date: 2008-12 Impact factor: 1.093
Authors: Jimmy K Wong; T Edward Kim; Seshadri C Mudumbai; Stavros G Memtsoudis; Nicholas J Giori; Steven K Howard; Roberta K Oka; Robert King; Edward R Mariano Journal: Clin Orthop Relat Res Date: 2019-01 Impact factor: 4.176
Authors: Sarah Tabbutt; Jennifer Schuette; Wenying Zhang; Jeffrey Alten; Janet Donohue; J William Gaynor; Nancy Ghanayem; Jeffrey Jacobs; Sara K Pasquali; Ravi Thiagarajan; Justin B Dimick; Mousumi Banerjee; David Cooper; Michael Gaies Journal: Pediatr Crit Care Med Date: 2019-02 Impact factor: 3.624
Authors: Ryan P Barbaro; Philip S Boonstra; Matthew L Paden; Lloyd A Roberts; Gail M Annich; Robert H Bartlett; Frank W Moler; Matthew M Davis Journal: Intensive Care Med Date: 2016-03-23 Impact factor: 17.440
Authors: Angira Patel; John M Costello; Carl L Backer; Sara K Pasquali; Kevin D Hill; Amelia S Wallace; Jeffrey P Jacobs; Marshall L Jacobs Journal: Ann Thorac Surg Date: 2016-06-17 Impact factor: 4.330
Authors: John T Berger; Richard Holubkov; Ron Reeder; David L Wessel; Kathleen Meert; Robert A Berg; Michael J Bell; Robert Tamburro; J Michael Dean; Murray M Pollack Journal: J Thorac Cardiovasc Surg Date: 2017-02-10 Impact factor: 5.209
Authors: Philip Allen; Farhan Zafar; Junhui Mi; Sarah Crook; Joyce Woo; Natalie Jayaram; Roosevelt Bryant; Tara Karamlou; James Tweddell; Kacie Dragan; Stephen Cook; Edward L Hannan; Jane W Newburger; Emile A Bacha; Robert Vincent; Khanh Nguyen; Kathleen Walsh-Spoonhower; Ralph Mosca; Neil Devejian; Steven A Kamenir; George M Alfieris; Michael F Swartz; David Meyer; Erin A Paul; John Billings; Brett R Anderson Journal: J Am Coll Cardiol Date: 2022-02-08 Impact factor: 24.094
Authors: David K Bailly; Ron W Reeder; Melissa Winder; Ryan P Barbaro; Murray M Pollack; Frank W Moler; Kathleen L Meert; Robert A Berg; Joseph Carcillo; Athena F Zuppa; Christopher Newth; John Berger; Michael J Bell; Michael J Dean; Carol Nicholson; Pamela Garcia-Filion; David Wessel; Sabrina Heidemann; Allan Doctor; Rick Harrison; Susan L Bratton; Heidi Dalton Journal: Pediatr Crit Care Med Date: 2019-05 Impact factor: 3.624