Initial application in the EACTS and STS Congenital Heart Surgery Databases of an empirically derived methodology of complexity adjustment to evaluate surgical case mix and results

Jacobs, Jeffrey P.; Jacobs, Marshall L.; Maruszewski, Bohdan; Lacour-Gayet, François; Tchervenkov, Christo I.; Tobota, Zdzisław; Stellin, Giovanni; Kurosawa, Hiromi; Murakami, Arata; Gaynor, J. William; Pasquali, Sara K.; Clarke, David R.; Austin, Erle H.; Mavroudis, Constantine

doi:10.1093/ejcts/ezs026

Cited by 132 publications

(105 citation statements)

References 17 publications

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“…Newly acquired diaphragm paralysis and vocal cord dysfunction were recorded and included in the analyses. A surgical encounter was defined as any that included a Society of Thoracic Surgeons index operation immediately before or during the encounter: operations with cardiopulmonary bypass or cardiovascular surgery without bypass, exclusive of patients <2.5kg undergoing isolated patent ductus arteriosus repair or undergoing operations that could not be classified into one of the Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery (STAT) mortality categories [13]. Medical encounters were those that did not include an index operation.…”

Section: Methodsmentioning

confidence: 99%

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Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Romans

Schwartz

Costello

et al. 2017

Pediatric Critical Care Medicine

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Objective To describe the epidemiology of noninvasive ventilation (NIV) therapy for patients admitted to pediatric cardiac intensive care units (CICU), and to assess practice variation across hospitals. Design Retrospective cohort study using prospectively collected clinical registry data. Setting Pediatric Cardiac Critical Care Consortium (PC4) clinical registry. Patients Patients admitted to CICUs at PC4 hospitals. Interventions None. Measurements and Main Results We analyzed all CICU encounters that included any respiratory support from 10/2013-12/2015. NIV therapy included high flow nasal cannula (HFNC) and positive airway pressure (PAP) support. We compared patient and, when relevant, perioperative characteristics of those receiving NIV to all others. Subgroup analysis was performed on neonates and infants undergoing major cardiovascular surgery. To examine duration of respiratory support we created a casemix-adjustment model and calculated adjusted mean durations of total respiratory support (MV + NIV), MV, and NIV. We compared adjusted duration of support across hospitals. The cohort included 8,940 encounters from 15 hospitals: 3,950 (44%) received NIV, 72% were neonates and infants. Medical encounters were more likely to include NIV than surgical. In surgical neonates and infants, 2,032 (55%) received postoperative NIV. Neonates, extracardiac anomalies, single ventricle, procedure complexity, preoperative respiratory support, MV duration, and postoperative disease severity were associated with NIV therapy (p<0.001 for all). Across hospitals, NIV use ranged from 32%-65%, and adjusted mean NIV duration ranged from 1-4 days (3 days observed mean). Duration of total adjusted respiratory support was more strongly correlated with duration of MV compared to NIV (Pearson's r=0.93 vs 0.71, respectively). Conclusions NIV use is common in CICUs, especially in patients admitted for medical conditions, infants, and those undergoing high complexity surgery. We observed wide variation in NIV use across hospitals, though the primary driver of total respiratory support time seems to be duration of MV.

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Section: Methodsmentioning

confidence: 99%

“…Medical encounters were those that did not include an index operation. The Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery (STAT) mortality categories were used to classify surgical complexity [13]. ICU length of stay was defined as admission date through critical care end date.…”

Section: Methodsmentioning

confidence: 99%

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Romans

Schwartz

Costello

et al. 2017

Pediatric Critical Care Medicine

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“…Electronic charts and the internal congenital heart surgery database were reviewed, and demographic and clinical data were collected. Surgical procedures were stratified based on complexity per the Society of Thoracic Surgeons and the European Association for Cardio-Thoracic Surgery (STAT) Mortality Categories (16). If available, the first arterial blood gas prior to cannulation for ECMO was collected (if a patient was cannulated in the operating room, then the blood gas prior to surgery was included).…”

Section: Methodsmentioning

confidence: 99%

Hyperoxia Is Associated With Poor Outcomes in Pediatric Cardiac Patients Supported on Venoarterial Extracorporeal Membrane Oxygenation*

Sznycer-Taub

Lowery

et al. 2016

Pediatric Critical Care Medicine

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In infants with congenital heart disease who are placed on venoarterial extracorporeal membrane oxygenation postoperatively, hyperoxia (defined as a mean PaO2 > 193 mm Hg in the first 48 hr of extracorporeal membrane oxygenation) was an independent risk factor for 30-day mortality after surgery. Future studies are needed to delineate the causative or associative role of hyperoxia with outcomes, especially in children with baseline cyanosis who may be more susceptible to the effects of oxidative stress.

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“…Bez dostępnego modelowania i projekcji symulującej sytuację obserwowaną "na żywo" szkolenie na tak zaawansowanym poziomie było trudne do przeprowadzenia, mimo wspomagania innymi sposobami wykorzystywanymi dotychczas w edukacji [3]. Dodatkowe, nowoczesne obrazowanie może się także stać pomocne we właściwej klasyfikacji i wciąż udoskonalanej nomenklaturze różnorodnych wad serca i naczyń oraz ich wariantów anatomicznych [19].…”

Section: Edukacjaunclassified

Nowoczesne obrazowanie z wykorzystaniem techniki wydruku 3D — technologia wspomagająca leczenie złożonych wrodzonych wad serca u dzieci

Jaworski¹,

Haponiuk

Chojnicki³

et al. 2016

Folia Cardiologica

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Initial application in the EACTS and STS Congenital Heart Surgery Databases of an empirically derived methodology of complexity adjustment to evaluate surgical case mix and results

Abstract: The STAT Mortality Categories facilitate analysis of outcomes across the wide spectrum of distinct congenital heart surgery operations including infrequently performed procedures.

Cited by 132 publications

References 17 publications

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Hyperoxia Is Associated With Poor Outcomes in Pediatric Cardiac Patients Supported on Venoarterial Extracorporeal Membrane Oxygenation*

Nowoczesne obrazowanie z wykorzystaniem techniki wydruku 3D — technologia wspomagająca leczenie złożonych wrodzonych wad serca u dzieci

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