Databases and Outcomes in Congenital Cardiac Anesthesia

Abstract

Anesthesia practitioners have long been at the forefront of patient safety initiatives in the operating room and beyond. The Congenital Cardiac Anesthesia Society has partnered with the Society of Thoracic Surgeons Congenital Heart Surgery Database to develop a patient registry for patients with congenital heart defects in order to determine patient outcomes related to anesthesia in this high-risk population. A review of existing database efforts is also undertaken to determine their strengths and weaknesses.

Invited Commentary: The Assessment of Outcomes and the Improvement of Quality of the Treatment of Patients With Congenital and Pediatric Cardiac Disease

“…The four preceding articles in this issue of The World Journal for Pediatric and Congenital Heart Surgery (WJPCHS) all focus on aspects of methodology related to outcomes assessment and quality improvement for congenital and pediatric cardiac disease. [5][6][7][8] A fifth article published later in this issue of WJPCHS also relates quite closely to this topic 9 and is published as part of the proceedings of PCICS 2010 (the Eighth International Conference of the Pediatric Cardiac Intensive Care Society, Miami Beach, Florida, USA; December 8-11, 2010). Each of these five articles adds new knowledge to previous work in this area and expands the rapidly evolving science of ''the assessment of outcomes and the improvement of quality of the treatment of patients with congenital and pediatric cardiac disease.…”

“…In their article titled “Databases and Outcomes in Congenital Cardiac Anesthesia,” Caplan and colleagues 7 describe the rationale for and development of the Congenital Cardiac Anesthesia Database of the Congenital Cardiac Anesthesia Society (CCAS) and the Society of Thoracic Surgeons (STS). Both CCAS and STS collaborated to develop a database to track anesthetic-related information for patients undergoing treatment of congenital and pediatric cardiac disease.…”

“…15 ) Just as the STS Congenital Heart Surgery Database is now used by the majority of programs in the United States, it is hoped that the CCAS-STS Congenital Cardiac Anesthesia Database will become a universal standard. This article by Caplan and colleagues 7 describes the science behind the operationalization of this new database. This article 7 is important not only because of the new knowledge generated related to the development and implementation of the CCAS-STS Congenital Cardiac Anesthesia Database, but also because of its demonstration of how the science of “the assessment of outcomes and the improvement of quality of the treatment of patients with congenital and pediatric cardiac disease” can span subspecialty boundaries.…”

“…The Congenital Cardiac Anesthesia Database of the Congenital Cardiac Anesthesia Society and the Society of Thoracic SurgeonsIn their article titled ''Databases and Outcomes in Congenital Cardiac Anesthesia,'' Caplan and colleagues7 describe the rationale for and development of the Congenital Cardiac Anesthesia Database of13,14 (The Report of the 2005 STS Congenital Heart Surgery Practice and Manpower Survey, undertaken by the STS Workforce on Congenital Heart Surgery, documented that 122 centers in the United States and 8 centers in Canada perform pediatric and congenital heart surgery 15. ) Just as the STS Congenital Heart Surgery Database is now used by the majority of programs in the United States, it is hoped that the CCAS-STS Congenital Cardiac Anesthesia Database will become a universal standard.…”

“…Indeed, we now believe that in order to perform meaningful multi-institutional analyses, any database must incorporate the following seven essential elements 1 –4 : use of a common language and nomenclature, use of a database with established uniform core data elements for collection of information, incorporation of a mechanism to evaluate case complexity, availability of a mechanism to assure and verify the completeness and accuracy of the data collected, collaboration between medical and surgical subspecialties, standardization of protocols for lifelong longitudinal follow-up. Incorporation of strategies for quality assessment and quality improvement. The four preceding articles in this issue of The World Journal for Pediatric and Congenital Heart Surgery ( WJPCHS ) all focus on aspects of methodology related to outcomes assessment and quality improvement for congenital and pediatric cardiac disease. 5 –8 A fifth article published later in this issue of WJPCHS also relates quite closely to this topic 9 and is published as part of the proceedings of PCICS 2010 (the Eighth International Conference of the Pediatric Cardiac Intensive Care Society, Miami Beach, Florida, USA; December 8-11, 2010). Each of these five articles adds new knowledge to previous work in this area and expands the rapidly evolving science of “the assessment of outcomes and the improvement of quality of the treatment of patients with congenital and pediatric cardiac disease.”…”