Journal article
Initial Application in The STS Congenital Database of Complexity Adjustment to Evaluate Surgical Case Mix and Results
The Annals of thoracic surgery, v 79(5), pp 1635-1649
2005
PMID: 15854945
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The analysis of the second harvest (1998–2001) of the Society of Thoracic Surgeons Congenital Heart Surgery Database included the first attempt by the STS to apply a complexity-adjustment method to evaluate congenital heart surgery results.
This data harvest represents the first STS multiinstitutional experience with software utilizing the international nomenclature and database specifications adopted by the STS and the European Association for Cardio-Thoracic Surgery (April 2000 Annals of Thoracic Surgery) and the first STS Congenital Database Report incorporating a methodology facilitating complexity adjustment. This methodology, allowing for complexity adjustment, gives each operation a basic complexity score (1.5 to 15) and level (1 to 4) based upon the work of the EACTS-STS Aristotle Committee, a panel of 50 expert surgeons. The complexity scoring, based on the primary procedure (from the EACTS-STS International Nomenclature Procedures Short List), estimates complexity through three factors: mortality potential, morbidity potential, and technical difficulty.
This STS harvest includes data from 16 centers reporting 12,787 cases, with discharge mortality known for 10,246 cases. The basic complexity score has been applied to the outcomes analysis of these cases and a new equation has been proposed to evaluate one aspect of performance: Aristotle Performance Index = Outcome × Complexity = (Survival) × (Mean Complexity Score)
The complexity analysis represents a basic complexity-adjustment method to evaluate surgical results. Complexity is a constant precise value for a given patient at a given point in time; performance varies between centers. Future STS congenital data harvests will incorporate a second step, the Comprehensive Aristotle Score, utilizing additional patient specific complexity modifiers to allow a more precise complexity adjustment.
Metrics
Details
- Title
- Initial Application in The STS Congenital Database of Complexity Adjustment to Evaluate Surgical Case Mix and Results
- Creators
- Jeffrey Phillip Jacobs - University of South Florida St. PetersburgFrancois G. Lacour-Gayet - Children's Hospital ColoradoMarshall Lewis Jacobs - St. Christopher's Hospital for ChildrenDavid Robinson Clarke - Children's Hospital ColoradoChristo I. Tchervenkov - Montreal Children's HospitalJ. William Gaynor - Children's Hospital of PhiladelphiaThomas L. Spray - Children's Hospital of PhiladelphiaBohdan Maruszewski - Children's Memorial Health InstituteGiovanni Stellin - University of PaduaJay Gould - University of South Florida St. PetersburgRachel S. Dokholyan - Duke UniversityEric D. Peterson - Duke UniversityMartin J. Elliott - Great Ormond Street HospitalConstantine Mavroudis - Childrens Memorial Hospital, Northwestern University, Chicago, IllinoisJane M Gould - Pediatrics
- Publication Details
- The Annals of thoracic surgery, v 79(5), pp 1635-1649
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000228876300028
- Scopus ID
- 2-s2.0-20944450770
- Other Identifier
- 991019168555504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery