Jacobs Jeffrey P, Jacobs Marshall L, Maruszewski Bohdan, Lacour-Gayet François G, Clarke David Robinson, Tchervenkov Christo I, Gaynor J William, Spray Thomas L, Stellin Giovanni, Elliott Martin J, Ebels Tjark, Mavroudis Constantine
The Congenital Heart Institute of Florida, St. Petersburg, Florida 33701, USA.
Ann Thorac Surg. 2005 Dec;80(6):2278-83; discussion 2283-4. doi: 10.1016/j.athoracsur.2005.05.107.
After utilizing separate congenital databases in the early 1990s, the Society of Thoracic Surgeons (STS) and the European Association for Cardio-Thoracic Surgery (EACTS) collaborated on several joint database initiatives.
In 1998, the joint EACTS-STS International Congenital Heart Surgery Nomenclature and Database Project Committee was created and a common nomenclature and common core minimum database dataset were adopted and published by the STS and the EACTS. In 1999, the joint EACTS-STS Aristotle Committee was created and the Aristotle Score was adopted and published as a method to provide complexity adjustment for congenital heart surgery. Collaborative efforts involving the EACTS and STS are underway to develop mechanisms to verify data completeness and accuracy.
Since 1998, this nomenclature, database, and methodology of complexity adjustment have been used by both the STS and EACTS to analyze outcomes of over 40,000 patients. A huge amount of data have been generated which allow comparison of practice patterns and outcomes analysis between Europe and North America. The aggregate data from the first 5 years of data collection not only make for interesting comparison but also allow examination of regional difference in practice patterns. For example, in the EACTS, out of 4,273 neonates, 885 (20.7%) underwent arterial switch procedures and 297 (6.95%) underwent Norwood stage 1 procedures. In the STS, out of 3,988 neonates, 472 (11.8%) underwent arterial switch procedures and 575 (14.4%) underwent Norwood stage 1 procedures.
This analysis of the EACTS-STS multi-institutional outcomes database confirms that in both Europe and North America, case complexity and mortality is highest among neonates, then infants, and then children. Regional differences in practice patterns are demonstrated, with the overall goal being the continued upgrade in the quality of surgery for congenital heart disease worldwide.
20世纪90年代初使用单独的先天性心脏病数据库后，胸外科医师协会（STS）和欧洲心胸外科协会（EACTS）就多个联合数据库项目展开了合作。
1998年，成立了EACTS-STS国际先天性心脏病手术命名与数据库项目联合委员会，STS和EACTS采用并发布了通用命名法和通用核心最小数据库数据集。1999年，成立了EACTS-STS亚里士多德委员会，采用并发布了亚里士多德评分，作为对先天性心脏病手术进行复杂性调整的一种方法。EACTS和STS正在共同努力，开发核实数据完整性和准确性的机制。
自1998年以来，STS和EACTS都使用了这种命名法、数据库和复杂性调整方法，对4万多名患者的手术结果进行分析。已经产生了大量数据，可用于比较欧洲和北美的手术模式及分析手术结果。头5年数据收集的汇总数据不仅有助于进行有趣的比较，还能考察手术模式的地区差异。例如，在EACTS的4273例新生儿中，885例（20.7%）接受了动脉调转术，297例（6.95%）接受了诺伍德一期手术。在STS的3988例新生儿中，472例（11.8%）接受了动脉调转术，575例（14.4%）接受了诺伍德一期手术。
对EACTS-STS多机构手术结果数据库的分析证实，在欧洲和北美，新生儿的病例复杂性和死亡率最高，其次是婴儿，然后是儿童。手术模式存在地区差异，总体目标是持续提升全球先天性心脏病手术的质量。
