The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2021 Update on Outcomes and Research

From “Informal Club” to “Authoritative Voice”: The Progression of CHSS to Become the Face of Congenital Heart Surgery

“…Rather, it showed that the STS model tends to slightly overestimate mortality rates for high-risk procedures. 3 Interestingly, this finding is entirely consistent with the previously published description of the validation and calibration of the model when it was originally presented and described in the Annals of Thoracic Surgery . 4 The analysis also identified a subset of palliative procedures (eg, Norwood, pulmonary artery band, and systemic-to-pulmonary artery shunt creation) for which the addition of the diagnosis to the procedure improved the risk model.…”

“…4 The analysis also identified a subset of palliative procedures (eg, Norwood, pulmonary artery band, and systemic-to-pulmonary artery shunt creation) for which the addition of the diagnosis to the procedure improved the risk model. 3 They also found 1% of the diagnosis-procedure categories accounted for 27% of the mortalities. 3 Adding confidence intervals for the expected mortality changed some centers’ observed:expected ratio and performance classification.…”

“…3 Adding confidence intervals for the expected mortality changed some centers’ observed:expected ratio and performance classification. 3 The STS is working to incorporate some of these findings into the database to further refine risk assessment.…”

Are outcomes in congenital cardiac surgery better than ever?

“…The authors reported the following mortalities for Categories 1, 2, 3, 4, and 5: 0.4%, 1.4%, 2.2%, 6.2%, and 13.3%, respectively. Most recently, Kumar et al 27 published the STS CHSD: 2021 Update on Outcomes and Research. This reports the aggregate mortality rates for Categories 1, 2, 3, 4, and 5 from 2016 to 2020 as 0.4%, 1.5%, 2.3%, 6.5%, and 20.0%.…”

Lessons learned from linking two complementary databases: the Society of Thoracic Surgeons Congenital Heart Surgery Database and The Vermont Oxford Network Expanded Database

“…Because most high-volume centres participate, nearly all congenital heart surgeries in the country are captured. 1 The database contains detailed patient demographics, pre-operative risk factors and comorbidities, diagnoses, procedure(s) performed, and surgical complications and outcomes, as well as extremely granular data about the surgical course and anaesthetic administration. Aggregate data are published twice yearly, and risk-adjusted centre-specific outcomes are publicly reported on a voluntary basis.…”