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美国胸外科协会先天性心脏病外科学会数据库:2019 年关于结果和质量的更新。

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2019 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. 2019 Mar;107(3):691-704. doi: 10.1016/j.athoracsur.2018.12.016. Epub 2019 Jan 11.

Abstract

The Society of Thoracic Surgeons Congenital Heart Surgery Database is a comprehensive clinical outcomes registry 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 report 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 2014 to December 2017. This analysis documents the overall aggregate Operative Mortality for operations performed at North American participants in The Society of Thoracic Surgeons Congenital Heart Surgery Database and the interquartile range (IQR) for participant-specific rates of Operative Mortality for the following procedural groups: off-bypass coarctation repair, 1.5% (IQR, 0.0% to 1.4%); ventricular septal defect repair, 0.5% (IQR, 0.0% to 0.5%); tetralogy of Fallot repair, 1.3% (IQR, 0.0% to 2.0%); complete atrioventricular canal repair, 2.5% (IQR, 0.0% to 4.1%); arterial switch operation, 2.2% (IQR, 0.0% to 3.0%); arterial switch operation and ventricular septal defect repair, 4.6% (IQR, 0.0% to 7.1%); Glenn/hemiFontan, 1.8% (IQR, 0.0% to 2.7%); Fontan operation, 1.0% (IQR, 0.0% to 0.4%); truncus arteriosus repair, 9.5% (IQR, 0.0% to 15.4%); and Norwood (stage 1) operation, 15.0% (IQR, 8.3% to 25.0%).

摘要

美国胸外科医师学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,涵盖了美国几乎所有的儿科心脏外科手术。它是美国胸外科医师学会开展与分析结果和改善该亚专科质量相关所有活动的平台。本报告总结了目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、绩效改进和透明度等相关领域的活动。报告中关于全国综合结果的数据是通过对 2014 年 1 月至 2017 年 12 月期间进行的 10 个基准手术组的分析来举例说明的。该分析记录了北美胸外科医师学会先天性心脏病外科学数据库参与者的手术操作总死亡率(Operative Mortality)以及以下手术组参与者特定手术操作死亡率(Operative Mortality)的四分位间距(IQR):非体外循环下的动脉导管未闭修复术为 1.5%(IQR,0.0%至 1.4%);室间隔缺损修补术为 0.5%(IQR,0.0%至 0.5%);法洛四联症修复术为 1.3%(IQR,0.0%至 2.0%);完全房室管修复术为 2.5%(IQR,0.0%至 4.1%);大动脉调转术为 2.2%(IQR,0.0%至 3.0%);大动脉调转术和室间隔缺损修补术为 4.6%(IQR,0.0%至 7.1%); Glenn/半 Fontan 术为 1.8%(IQR,0.0%至 2.7%);Fontan 手术为 1.0%(IQR,0.0%至 0.4%);共同动脉干修复术为 9.5%(IQR,0.0%至 15.4%);以及 Norwood(一期)手术为 15.0%(IQR,8.3%至 25.0%)。

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