Richard E. Clark awardVariation in Outcomes for Benchmark Operations: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database
Section snippets
Study Population
The study population included patients who underwent operations with one of the primary procedures listed in Table 1 and who met the inclusionary and exclusionary criteria also listed in Table 1. Patients undergoing arterial switch operation (ASO) are in a separate cohort from those undergoing ASO + ventricular septal defect (VSD) repair because the outcomes of these 2 groups are quite different [6]. Furthermore the presence or absence of a VSD is a nonmodifiable variable that is an intrinsic
Results
From 2005 to 2009 inclusive, 85 centers (United States and Canada) submitted data to STS-CHSDB, and the discharge mortality of index cardiac operations was 4.0% (3,418/86,297). For patients younger than 18 years, from 2005 to 2009 inclusive, 85 centers submitted data to STS-CHSDB, and the discharge mortality of index cardiac operations was 4.1% (3,309/81,062). Eighteen thousand three hundred seventy-five index operations at 74 centers were included in this analysis of 8 benchmark operations.
Comment
The STS-CHSDB is the largest congenital heart surgery database in North America. This analysis documents (1) contemporary benchmarks for common pediatric cardiac surgical operations of varying levels of complexity and (2) the degree of variation in outcome between centers. Variation in outcome was most prominent for the more complex operations. These data can aid in quality assessment and quality improvement initiatives. Variation in outcomes across centers demonstrates opportunities for
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