Paparella Domenico, Guida Pietro, Bisceglia Lucia, Caparrotti Sergio, Carbone Carmine, Cassese Mauro, Contini Marco, de Luca Tupputi Schinosa Luigi, De Pasquale Claudio, Di Eusanio Giuseppe, Fanelli Vitantonio, Gregorini Renato, Martinelli Gianluca, Mazzei Valerio, Rocco Domenico, Speziale Giuseppe, Visicchio Giuseppe, Zaccaria Salvatore, Fiore Tommaso, Bux Francesco
aDivision of Cardiac Surgery, Department of Emergency and Organ Transplant, University of Bari Aldo Moro bPuglia Health Regional Agency cDepartment of Cardiac Surgery, Villa Bianca Hospital dDepartment of Cardiac Surgery, Santa Maria Hospital, Bari eDepartment of Cardiac Surgery, Villa Verde Hospital, Taranto fDepartment of Cardiac Surgery, Città di Lecce Hospital gDepartment of Cardiac Surgery, Vito Fazzi Hospital, Lecce hDepartment of Cardiac Surgery, Anthea Hospital iDivision of Anesthesia, Department of Emergency and Organ Transplant, University of Bari Aldo Moro, Bari, Italy.
J Cardiovasc Med (Hagerstown). 2014 Nov;15(11):810-6. doi: 10.2459/JCM.0000000000000115.
To evaluate the feasibility of a cardiac surgery registry and to describe patients' characteristics, type of procedures performed, incidence of postoperative complications with short and middle-term mortality.
A database with clinical information and details on cardiac surgical operations was implemented by Puglia Health Regional Agency to collect data of each cardiac surgery procedure performed in the seven adult cardiac surgery centres of the region. Health regional agency personnel guaranteed data accuracy and quality control procedures. Mortality after the discharge was evaluated for residents in Puglia by linking clinical data to the Health Information System.
From January 2011 to December 2012, 6429 operations were performed. All operations were included in the registry with very high completeness of collected data (95.3% per patient). The majority of the operations performed were coronary artery bypass graft alone (41.1%), valve surgery alone (26.2%), coronary artery bypass graft and valve surgery (11.4%), or valve with other surgery (11.8%). During a median follow-up of 12 months (interquartile range 6-18 months), 211 deaths were detected after the discharge. Overall, cumulative mortality from the operation was 8.2% at 6 months and 9.5% at 12 months.
Implementation of a regional clinical registry of cardiac surgery is feasible with a great level of accuracy and the evaluation of mid-term mortality overcomes the limited value of hospital mortality. An accurate cardiac surgery registry elicits epidemiologic evaluations, comparisons between expected and observed mortality, incidence of postoperative complications and encourages a reliable public reporting.
评估心脏手术登记系统的可行性，并描述患者特征、所实施手术的类型、术后并发症发生率以及短期和中期死亡率。
普利亚大区卫生机构建立了一个包含临床信息和心脏外科手术详细资料的数据库，以收集该地区七个成人心脏外科中心实施的每例心脏手术的数据。大区卫生机构人员确保数据准确性和质量控制程序。通过将临床数据与健康信息系统相链接，对普利亚大区居民出院后的死亡率进行评估。
2011年1月至2012年12月期间，共实施了6429例手术。所有手术均被纳入登记系统，所收集数据的完整性非常高（每位患者95.3%）。实施的手术大多数为单纯冠状动脉搭桥术（41.1%）、单纯瓣膜手术（26.2%）、冠状动脉搭桥术和瓣膜手术（11.4%）或瓣膜手术合并其他手术（11.8%）。在中位随访12个月（四分位间距6 - 18个月）期间，出院后检测到211例死亡。总体而言，术后6个月累计死亡率为8.2%，12个月时为9.5%。
实施地区性心脏手术临床登记系统是可行的，且准确性很高，中期死亡率评估克服了医院死亡率的局限性。准确的心脏手术登记系统有助于进行流行病学评估、预期死亡率与观察到的死亡率之间的比较、术后并发症发生率的统计，并鼓励进行可靠的公开报告。
