Jeffrey P Jacobs1, Xia He2, John E Mayer3, Erle H Austin4, James A Quintessenza5, Tom R Karl6, Luca Vricella5, Constantine Mavroudis5, Sean M O'Brien2, Sara K Pasquali7, Kevin D Hill2, S Adil Husain8, David M Overman9, James D St Louis10, Jane M Han11, David M Shahian12, Duke Cameron5, Marshall L Jacobs5. 1. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida. Electronic address: jeffjacobs@msn.com. 2. Duke University, Durham, North Carolina. 3. Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts. 4. Kosair Children's Hospital, University of Louisville, Louisville, Kentucky. 5. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida. 6. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida; Discipline of Surgery, University of Queensland School of Medicine, Brisbane, Australia. 7. C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan. 8. University of Texas Health Sciences Center-San Antonio/University Health Systems, San Antonio, Texas. 9. The Children's Heart Clinic at Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota. 10. Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri. 11. The Society of Thoracic Surgeons, Chicago, Illinois. 12. Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Database (STS CHSD) was queried to assess multiinstitutional trends over time in discharge mortality and postoperative length of stay (PLOS). METHODS: Since 2009, operations in the STS CHSD have been classified according to STAT (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery) Congenital Heart Surgery Mortality Categories. The five STAT Mortality Categories were chosen to be optimal with respect to minimizing variation within categories and maximizing variation between categories. For this study, all index cardiac operations from 1998 to 2014, inclusive, were grouped by STAT Mortality Category (exclusions: patent ductus arteriosus ligation in patients weighing less than or equal to 2.5 kg and operations that could not be assigned to a STAT Mortality Category). End points were discharge mortality and PLOS in survivors for the entire period and for 4-year epochs. The Cochran-Armitage trend test was used to test the null hypothesis that the mortality was the same across epochs, by STAT Mortality Category. RESULTS: The analysis encompassed 202,895 index operations at 118 centers. The number of centers participating in STS CHSD increased in each epoch. Overall discharge mortality was 3.4% (6,959 of 202,895) for 1998 to 2014 and 3.1% (2,308 of 75,337) for 2011 to 2014. Statistically significant improvement in discharge mortality was seen in STAT Mortality Categories 2, 3, 4, and 5 (p values for STAT Mortality Categories 1 through 5 are 0.060, <0.001, 0.015, <0.001, and <0.001, respectively). PLOS in survivors was relatively unchanged over the same time intervals. Sensitivity analyses reveal that the finding of declining risk-stratified rates of discharge mortality over time is not simply attributable to the addition of more centers to the cohort over time. CONCLUSIONS: This 16-year analysis of STS CHSD reveals declining discharge mortality over time, especially for more complex operations.
BACKGROUND: Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Database (STS CHSD) was queried to assess multiinstitutional trends over time in discharge mortality and postoperative length of stay (PLOS). METHODS: Since 2009, operations in the STS CHSD have been classified according to STAT (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery) Congenital Heart Surgery Mortality Categories. The five STAT Mortality Categories were chosen to be optimal with respect to minimizing variation within categories and maximizing variation between categories. For this study, all index cardiac operations from 1998 to 2014, inclusive, were grouped by STAT Mortality Category (exclusions: patent ductus arteriosus ligation in patients weighing less than or equal to 2.5 kg and operations that could not be assigned to a STAT Mortality Category). End points were discharge mortality and PLOS in survivors for the entire period and for 4-year epochs. The Cochran-Armitage trend test was used to test the null hypothesis that the mortality was the same across epochs, by STAT Mortality Category. RESULTS: The analysis encompassed 202,895 index operations at 118 centers. The number of centers participating in STS CHSD increased in each epoch. Overall discharge mortality was 3.4% (6,959 of 202,895) for 1998 to 2014 and 3.1% (2,308 of 75,337) for 2011 to 2014. Statistically significant improvement in discharge mortality was seen in STAT Mortality Categories 2, 3, 4, and 5 (p values for STAT Mortality Categories 1 through 5 are 0.060, <0.001, 0.015, <0.001, and <0.001, respectively). PLOS in survivors was relatively unchanged over the same time intervals. Sensitivity analyses reveal that the finding of declining risk-stratified rates of discharge mortality over time is not simply attributable to the addition of more centers to the cohort over time. CONCLUSIONS: This 16-year analysis of STS CHSD reveals declining discharge mortality over time, especially for more complex operations.
Authors: Rie Sakai-Bizmark; Laurie A Mena; Hiraku Kumamaru; Ichiro Kawachi; Emily H Marr; Eliza J Webber; Hyun H Seo; Scott I M Friedlander; Ruey-Kang R Chang Journal: Health Serv Res Date: 2019-03-27 Impact factor: 3.402
Authors: Martin Bennett; Clarke Thuys; Simon Augustin; Brad Schultz; Steve Bottrell; Alison Horton; Andrzej Bednarz; Steve Horton Journal: J Extra Corpor Technol Date: 2018-12
Authors: Lydia K Wright; Rachel Zmora; Yijian Huang; Matthew E Oster; Courtney McCracken; William T Mahle; Lazaros Kochilas; Andreas Kalogeropoulos Journal: Am J Cardiol Date: 2022-01-03 Impact factor: 2.778
Authors: Sara Bobillo-Perez; Monica Girona-Alarcon; Debora Cañizo; Marta Camprubi-Camprubi; Javier Rodriguez-Fanjul; Monica Balaguer; Sergio Benito; Anna Valls; Francisco Jose Cambra; Iolanda Jordan Journal: Eur J Pediatr Date: 2021-10-22 Impact factor: 3.183
Authors: Carolina Putotto; Flaminia Pugnaloni; Marta Unolt; Stella Maiolo; Matteo Trezzi; Maria Cristina Digilio; Annapaola Cirillo; Giuseppe Limongelli; Bruno Marino; Giulio Calcagni; Paolo Versacci Journal: Children (Basel) Date: 2022-05-25
Authors: Monique M Gardner; Garrett Keim; Jill Hsia; Anh D Mai; J William Gaynor; Andrew C Glatz; Nadir Yehya Journal: J Am Heart Assoc Date: 2022-06-14 Impact factor: 6.106
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