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美国胸外科协会先天性心脏病数据库:2018 年结局和质量更新。

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2018 Update on Outcomes and Quality.

机构信息

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.

Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

出版信息

Ann Thorac Surg. 2018 Mar;105(3):680-689. doi: 10.1016/j.athoracsur.2018.01.001. Epub 2018 Jan 11.

Abstract

The Society of Thoracic Surgeons Congenital Heart Surgery Database is a comprehensive registry of clinical outcomes that captures almost all pediatric cardiac surgical operations in the United States. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This article summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency. The reported data about aggregate national outcomes are exemplified by an analysis of 10 benchmark operation groups performed from January 2013 through December 2016. This analysis documents the overall aggregate Operative Mortality (interquartile range among all participating programs) for the following procedural groups: off-bypass coarctation repair, 1.3% (0.0% to 1.4%%); ventricular septal defect repair, 0.6% (0.0% to 0.9%); tetralogy of Fallot repair, 1.1% (0.0% to 2.0%); complete atrioventricular canal repair, 2.7% (0.0% to 4.4%); arterial switch operation, 2.2% (0.0% to 2.9%); arterial switch operation and ventricular septal defect repair, 5.1% (0.0% to 8.3%); Glenn/HemiFontan, 2.1% (0.0% to 3.1%); Fontan operation, 1.1% (0.0% to 0.0%); truncus arteriosus repair, 10.1% (0.0% to 15.4%); and Norwood procedure, 15.8% (9.0% to 25.0%).

摘要

美国胸外科协会先天性心脏病外科学数据库是一个全面的临床结果注册系统,几乎涵盖了美国所有儿科心脏手术。它是美国胸外科协会所有与分析结果和提高该亚专业质量相关活动的平台。本文总结了当前先天性和儿科心脏外科学的全国综合结果,并回顾了质量测量、绩效改进和透明度方面的相关活动。报告的全国综合结果数据通过对 2013 年 1 月至 2016 年 12 月期间进行的 10 个基准手术组的分析进行举例说明。该分析记录了以下手术组的总体手术死亡率(所有参与项目的四分位间距):体外循环下主动脉缩窄修复术为 1.3%(0.0%至 1.4%);室间隔缺损修补术为 0.6%(0.0%至 0.9%);法洛四联症修复术为 1.1%(0.0%至 2.0%);完全性房室管修复术为 2.7%(0.0%至 4.4%);大动脉调转术为 2.2%(0.0%至 2.9%);大动脉调转术和室间隔缺损修补术为 5.1%(0.0%至 8.3%);Glenn/HemiFontan 术为 2.1%(0.0%至 3.1%);Fontan 手术为 1.1%(0.0%至 0.0%);共同动脉干修复术为 10.1%(0.0%至 15.4%);和 Norwood 手术为 15.8%(9.0%至 25.0%)。

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