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Analysis of regional congenital cardiac surgical outcomes in Florida using The Society of Thoracic Surgeons Congenital Heart Surgery Database

Part of: The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD)

Published online by Cambridge University Press:  01 August 2009

Jeffrey P. Jacobs ,
James A. Quintessenza ,
Redmond P. Burke ,
Mark S. Bleiweis ,
Barry J. Byrne ,
Eric L. Ceithaml ,
William M. DeCampli ,
Jorge M. Giroud ,
Richard A. Perryman  and
Eliot R. Rosenkranz
...Show all authors
Jeffrey P. Jacobs*
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital and Saint Joseph’s Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), Saint Petersburg and Tampa, Florida, United States of America
James A. Quintessenza
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital and Saint Joseph’s Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), Saint Petersburg and Tampa, Florida, United States of America
Redmond P. Burke
Affiliation:
The Congenital Heart Institute of Miami Children’s Hospital and Arnold Palmer Children’s Hospital, Miami and Orlando, Florida, United States of America
Mark S. Bleiweis
Affiliation:
The University of Florida, Gainesville and Jacksonville, Florida, United States of America
Barry J. Byrne
Affiliation:
The University of Florida, Gainesville and Jacksonville, Florida, United States of America
Eric L. Ceithaml
Affiliation:
The University of Florida, Gainesville and Jacksonville, Florida, United States of America
William M. DeCampli
Affiliation:
The Congenital Heart Institute of Miami Children’s Hospital and Arnold Palmer Children’s Hospital, Miami and Orlando, Florida, United States of America
Jorge M. Giroud
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital and Saint Joseph’s Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), Saint Petersburg and Tampa, Florida, United States of America
Richard A. Perryman
Affiliation:
Joe DiMaggio Children’s Hospital, Hollywood, Florida, United States of America
Eliot R. Rosenkranz
Affiliation:
The University of Miami, Miami, Florida, United States of America
Grace Wolff
Affiliation:
The University of Miami, Miami, Florida, United States of America
Vicki Posner
Affiliation:
Florida Children’s Medical Services (CMS), Tallahassee, Florida, United States of America
Sue Steverson
Affiliation:
Florida Children’s Medical Services (CMS), Tallahassee, Florida, United States of America
William B. Blanchard
Affiliation:
Nemours Children’s Clinic and Sacred Heart Children’s Hospital, Pensacola, Florida, United States of America
Gerry L. Schiebler
Affiliation:
Florida Children’s Medical Services, Tallahassee, Florida, United States of America
*
Correspondence to: Jeffrey P. Jacobs, M.D., FACS, FACC, FCCP, Cardiovascular and Thoracic Surgeon, Surgical Director of Heart Transplantation and ECMO, The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children's Hospital and Saint Joseph's Children's Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), 625 Sixth Avenue South, Suite 475, Saint Petersburg, Florida 33701, United States of America. Tel: (727) 822-6666; Fax: (727) 821-5994; E-mail: JeffJacobs@msn.com; Web page: http://www.heartsurgery-csa.com/, Web Page: http://www.CHIF.us/
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Abstract

Background

Florida is the fourth largest state in the United States of America. In 2004, 218,045 live babies were born in Florida, accounting for approximately 1744 new cases of congenital heart disease. We review the initial experience of The Society of Thoracic Surgeons Congenital Heart Surgery Database with a regional outcomes report, namely the Society of Thoracic Surgeons Florida Regional Report.

Methods

Eight centres in Florida provide services for congenital cardiac surgery. The Children’s Medical Services of Florida provide a framework for quality improvement collaboration between centres. All congenital cardiac surgical centres in Florida have voluntarily agreed to submit data to the Society of Thoracic Surgeons Database. The Society of Thoracic Surgeons and Duke Clinical Research Institute prepared a Florida Regional Report to allow detailed regional analysis of outcomes for congenital cardiac surgery.

Results

The report of 2007 from the Society of Thoracic Surgeons Congenital Heart Surgery Database includes details of 61,014 operations performed during the 4 year data harvest window, which extended from 2003 through 2006. Of these operations, 6,385 (10.5%) were performed in Florida. Discharge mortality in the data from Florida overall, and from each Florida site, with 95% confidence intervals, is not different from cumulative data from the entire Society of Thoracic Surgeons Database, both for all patients and for patients stratified by complexity.

Conclusions

A regional consortium of congenital heart surgery centres in Florida under the framework of the Children’s Medical Services has allowed for inter-institutional collaboration with the goal of quality improvement. This experience demonstrates, first, that the database maintained by the Society of Thoracic Surgeons can provide the framework for regional analysis of outcomes, and second, that voluntary regional collaborative efforts permit the pooling of data for such analysis.

Keywords

Paediatric heart surgerysurgical outcomescongenital heart diseaseregistrypatient safety
Type
Original Articles
Information
Cardiology in the Young , Volume 19 , Issue 4 , August 2009 , pp. 360 - 369
Copyright
Copyright © Cambridge University Press 2009

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References

1.Kohn, LT, Corrigan, JM, Donaldson, M, (eds). Committee on Quality of Health Care in America, Institute of Medicine (IOM) Report—To Err Is Human: Building a Safer Health System. Washington, DC: National Academy of Sciences; 2000. (Free Executive Summary). [http://www.nap.edu/catalog/9728.html], accessed October 11, 2007.Google Scholar
2. [http://www.qualityforum.org/], accessed October 11, 2007.Google Scholar
3.Jacobs, ML, Mavroudis, C, Jacobs, JP, Tchervenkov, CI, Pelletier, GJ. Report of the 2005 STS Congenital Heart Surgery Practice and Manpower Survey. Ann Thorac Surg 2006; 82: 1152–1158, 1159e1-5; discussion 1158–9.CrossRefGoogle ScholarPubMed
4.Jacobs, JP, Jacobs, ML, Mavroudis, C, et al. Nomenclature and databases for the surgical treatment of congenital cardiac disease – an updated primer and an analysis of opportunities for improvement. In: 2008 Cardiology in the Young Supplement: Databases and The Assessment of Complications associated with The Treatment of Patients with Congenital Cardiac Disease, Prepared by: The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease, Jeffrey P. Jacobs, MD (ed.). Cardiol Young 2008; 18 (Suppl. 2), S2.38–62, December 9, 2008.CrossRefGoogle Scholar
5.Jacobs, JP, Jacobs, ML, Mavroudis, C, Lacour-Gayet, FG, Tchervenkov, CI. Executive Summary: The Society of Thoracic Surgeons Congenital Heart Surgery Database – Ninth Harvest – (July 1, 2004–June 30, 2008). The Society of Thoracic Surgeons (STS) and Duke Clinical Research Institute (DCRI), Duke University Medical Center, Durham, North Carolina, United States, Fall 2008 Harvest.Google Scholar
6.Jacobs, JP, Mavroudis, C, Jacobs, ML, et al. Lessons learned from the data analysis of the Second Harvest (1998–2001) of the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database. Eur J Cardiothorac Surg 2004; 26: 18–37.Google Scholar
7.Jacobs, JP, Lacour-Gayet, FG, Jacobs, ML, et al. Initial application in the STS congenital database of complexity adjustment to evaluate surgical case mix and results. Ann Thorac Surg 2005; 79: 1635–1649.CrossRefGoogle ScholarPubMed
8.Jacobs, JP, Jacobs, ML, Maruszewski, B, et al. Current status of the European Association for Cardio-Thoracic Surgery and the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg 2005; 80: 2278–2283; discussion 2283–4.CrossRefGoogle Scholar
9.Jacobs, JP, Mavroudis, C, Jacobs, ML, et al. What is operative mortality? Defining death in a surgical registry database: a report from the STS Congenital Database Task Force and the Joint EACTS-STS Congenital Database Committee. Ann Thorac Surg 2006; 81: 1937–1941.Google Scholar
10.Jacobs, JP, Jacobs, ML, Mavroudis, C, et al. What is operative morbidity? Defining complications in a surgical registry database: a report from the STS Congenital Database Task Force and the Joint EACTS-STS Congenital Database Committee. Ann Thorac Surg 2007; 84: 1416–1421.Google Scholar
11.Jacobs, JP, Mavroudis, C, Jacobs, ML, et al. Nomenclature and databases—the past, the present, and the future: a primer for the congenital heart surgeon. Pediatr Cardiol 2007; 28: 105–115. Epub 2007 May 4.CrossRefGoogle ScholarPubMed
12.Jacobs, JP, Wernovsky, G, Elliott, MJ. Analysis of outcomes for congenital cardiac disease: can we do better? In 2007 Supplement to Cardiology in the Young: Controversies and Challenges Facing Paediatric Cardiovascular Practitioners and their Patients. Jacobs JP, Wernovsky G, Gaynor JW, and Anderson RH (eds). Cardiol Young 2007; 17 (Suppl 2): 145–158, doi:10.1017/S1047951107001278.Google Scholar
13.Lacour-Gayet, F. Risk stratification theme for congenital heart surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2002; 5: 148–152.Google Scholar
14.Lacour-Gayet, FG, Clarke, D, Jacobs, JP, et al. , and the Aristotle Committee. The Aristotle Score: A Complexity-Adjusted Method to Evaluate Surgical Results. Eur J Cardiothorac Surg 2004; 25: 911–924.CrossRefGoogle Scholar
15.Lacour-Gayet, FG, Clarke, D, Jacobs, JP, et al. , and the Aristotle Committee. The Aristotle Score for Congenital Heart Surgery. 2004 Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2004; 7: 185–191.Google ScholarPubMed
16.Jenkins, KJ, Gauvreau, K, Newburger, JW, Spray, TL, Moller, JH, Iezzoni, LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002; 123: 110–118.Google Scholar
17.Jenkins, KJ. Risk adjustment for congenital heart surgery: The RACHS-1 method. 2004 Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2004; 7: 180–184.CrossRefGoogle Scholar
18.Jacobs, JP, Jacobs, ML, Mavroudis, C, Lacour-Gayet, FG, Tchervenkov CI. Executive Summary: The Society of Thoracic Surgeons Congenital Heart Surgery Database – Seventh Harvest – (2003–2006). The Society of Thoracic Surgeons (STS) and Duke Clinical Research Institute (DCRI), Duke University Medical Center, Durham, North Carolina, United States, Spring 2007 Harvest.Google Scholar
19.Jacobs, JP, Quintessenza, JA. Current Efforts to Create a Global Congenital Heart Surgery Database: How the Florida CMS Database Can Play a Major Role. Presented at the Florida CMS Meeting, Howey-in-the-Hills, Florida, Friday, September 10, 2004.Google Scholar
20.Jacobs, JP, Quintessenza, JA. Update from Congenital Heart Surgery Database Task Force Current Status and Future Directions for the STS Database. Presented at the Florida CMS Meeting, Orlando, Florida, Monday, October 09, 2006.Google Scholar
21.Jacobs, JP, Franklin, RCG, Wilkinson, JL, et al. The nomenclature, definition and classification of discordant atrioventricular connections. In 2006 Supplement to Cardiology in the Young: Controversies and Challenges of the Atrioventricular Junctions and Other Challenges Facing Paediatric Cardiovascular Practitioners and their Patients, Jacobs JP, Wernovsky G, Gaynor JW, and Anderson RH (eds). Cardiol Young 2006; 16 (Suppl 3): S3.72-84.Google Scholar
22.Jacobs, JP, Cerfolio, RJ, Sade, RM. The Ethics of Transparency: Publication of Cardiothoracic Surgical Outcomes in the Lay Press. Accepted for publication Friday December 12, 2008. The Annals of Thoracic Surgery, 2009 Mar; 87(3): 679–686. PMID: 19231369, March 2009.CrossRefGoogle Scholar