STS Adult CV Surgery National Database - Fall 2003 Executive Summary Contents

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Nội dung Text: STS Adult CV Surgery National Database - Fall 2003 Executive Summary Contents

STS Adult CV Surgery National Database - Fall 2003 Executive Summary Contents

Figure 1. Cumulative Number of Participating Sites
Figure 2. Cumulative Number of Procedures Performed
Figure 3. Cumulative Number of Isolated CAB Procedures Performed
Figure 4. Unadjusted Isolated CAB Operative Mortality
Figure 5. Risk-Adjusted Isolated CAB Operative Mortality
Figure 6. Post-Procedure Length of Stay for Isolated CAB Procedures
Figure 7. Cumulative Number of Aortic Valve Procedures Performed
Figure 8. Unadjusted Aortic Valve Operative Mortality
Figure 9. Risk-Adjusted Aortic Valve Operative Mortality
Figure 10. Mean Post-Procedure Length of Stay for Aortic Valve Procedures
Figure 11. Cumulative Number of Mitral Valve Procedures Performed
Figure 12. Unadjusted Mitral Valve Operative Mortality
Figure 13. Risk-Adjusted Mitral Valve Operative Mortality
Figure 14. Mean Post-Procedure Length of Stay for Mitral Valve Procedures
Figure 15. Cumulative Number of Selected Other Cardiac Procedures Performed
Figure 16. Unadjusted Other Cardiac Operative Mortality
Figure 17. Mean Post-Procedure Length of Stay for Other Cardiac Procedures
Figure 18. Cumulative Number of Selected Other Non-Cardiac Procedures Performed
Figure 19. Unadjusted Other Non-Cardiac Operative Mortality
Figure 20. Mean Post-Procedure Length of Stay for Other Non-Cardiac Procedures


Table 1 - January 1994 to June 2003 Procedure Distribution

Yearly Number of Sites in Analysis
Yearly Overall Procedure Count
Major Procedures Distribution
Incidence of Other Procedures Distribution
Figure 1:
Number of Participating Sites Over Last 10 Years
900


750
Cumulative Count




600


450


300


150


0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year




Figure 2:
Number of Procedures Performed Over Last 10 Years
2,400,000


2,000,000
Cumulative Count




1,600,000


1,200,000


800,000


400,000


0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year
Figure 3:
Number of Isolated CAB Procedures Performed Over Last 10 Years
1,500,000



1,200,000
Cumulative Count




900,000



600,000



300,000



0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year




Figure 4:
Unadjusted Isolated CAB Operative Mortality
6%


5%


4%
Percent




3%


2%


1%


0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year
Figure 5:
Risk-Adjusted Isolated CAB Operative Mortality
6%


5%


4%
Percent




3%


2%


1%


0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year




Figure 6:
Post-Procedure Length of Stay for Isolated CAB Procedures
10



8



6
Days




4



2



0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Mean Median
Figure 7:
Number of Aortic Valve Procedures Performed Over Last 10 Years
100,000

90,000

80,000
Cumulative Count




70,000

60,000

50,000

40,000

30,000

20,000

10,000

0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

AV Replace AV Replace + CAB
AV Replace + MV Replace



Figure 8:
Unadjusted Aortic Valve Operative Mortality
15%




10%
Percent




5%




0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

AV Replace AV Replace + CAB
AV Replace + MV Replace
Figure 9:
Risk-Adjusted Aortic Valve Operative Mortality
10%



8%



6%
Percent




4%



2%



0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

AV Replace
AV Replace + CAB



Figure 10:
Mean Post-Procedure Length of Stay for Aortic Valve Procedures
20




15
Mean Days




10




5




0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

AV Replace AV Replace + CAB
AV Replace + MV Replace
Figure 11:
Number of Mitral Valve Procedures Performed Over Last 10 Years
50,000



40,000
Cumulative Count




30,000



20,000



10,000



0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

MV Replace MV Replace + CAB
MV Repair MV Repair + CAB



Figure 12:
Unadjusted Mitral Valve Operative Mortality
20%




15%
Percent




10%




5%




0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

MV Replace MV Replace + CAB
MV Repair MV Repair + CAB
Figure 13:
Risk-Adjusted Mitral Valve Operative Mortality
20%




15%
Percent




10%




5%




0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

MV Replace
MV Replace + CAB



Figure 14:
Mean Post-Procedure Length of Stay for Mitral Valve Procedures
20




15
Mean Days




10




5




0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

MV Replace MV Replace + CAB
MV Repair MV Repair + CAB
Figure 15:
Number of Selected Other Cardiac Procedures Performed Over Last 10 Years
20,000



16,000
Cumulative Count




12,000



8,000



4,000



0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Left Ventricular Aneurysm Ventricular Septal Defect
Pulmonary Valve Tricuspid Valve



Figure 16:
Unadjusted Other Cardiac Operative Mortality
50%



40%



30%
Percent




20%



10%



0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Left Ventricular Aneurysm Ventricular Septal Defect
Pulmonary Valve Tricuspid Valve
Figure 17:
Mean Post-Procedure Length of Stay for Other Cardiac Procedures
20




15
Mean Days




10




5




0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Left Ventricular Aneurysm Ventricular Septal Defect
Pulmonary Valve Tricuspid Valve



Figure 18:
Number of Selected Other Non-Cardiac Procedures Performed Over Last 10 Years

40,000

35,000

30,000
Cumulative Count




25,000

20,000

15,000

10,000

5,000

0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Aortic Aneurysm
Carotid Endarterectomy
Figure 19:
Unadjusted Other Non-Cardiac Operative Mortality
25%



20%



15%
Percent




10%



5%



0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Aortic Aneurysm
Carotid Endarterectomy



Figure 20:
Mean Post-Procedure Length of Stay for Other Non-Cardiac Procedures
20




15
Mean Days




10




5




0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Procedure Year

Aortic Aneurysm
Carotid Endarterectomy
Table 1:
The Society of Thoracic Surgeons
National Adult Cardiac Surgery Database
Jan 1994 to Jun 2003 Procedure Distribution

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

337 404 452 466 460 380 363 419 481 431
Yearly Number of Sites in Analysis
152,064 200,293 235,377 252,688 240,590 210,295 200,451 204,305 222,523 100,131
Yearly Overall Procedure Count

Major Procedures
Isolated CAB 115,679 153,414 182,911 192,543 181,774 155,831 146,086 145,497 153,650 67,483
Isolated Aortic Valve Replace 6,367 7,836 8,969 9,932 10,108 9,108 9,025 9,602 11,062 5,251
Isolated Mitral Valve Replace 3,057 3,800 4,275 5,048 5,134 4,303 4,209 4,124 4,380 1,817
Aortic Valve Replace + CAB 5,707 7,552 9,212 10,444 10,908 10,045 9,921 10,361 11,751 5,506
Mitral Valve Replace + CAB 1,955 2,629 3,003 3,467 3,575 3,106 2,899 2,805 2,949 1,249
Aortic + Mitral Valve Replace 775 959 1,086 1,230 1,191 1,037 1,008 959 1,011 457
Mitral Valve Repair 982 1,256 1,586 2,234 2,262 2,086 2,331 2,750 3,659 1,690
Mitral Valve Repair + CAB 994 1,427 1,753 2,297 2,239 1,957 2,517 3,162 3,886 1,913

Not Classified Above 16,548 21,420 22,582 25,493 23,399 22,822 22,455 25,045 30,175 14,765

Incidence of Other Procedures
Pulmonary Valve 147 199 373 461 543 529 449 463 486 217
Tricuspid Valve 909 1,292 1,410 1,880 1,751 1,666 1,787 2,272 3,158 1,695
LVA - Left Ventrical Aneurysm Repair 615 852 1,095 1,180 1,057 1,046 728 885 1,057 465
VSD - Ventricular Septal Defect Repair 335 476 518 576 525 547 409 422 455 204
ASD - Atrial Septal Defect Repair 971 1,354 1,601 1,934 1,852 2,005 1,921 2,121 2,373 1,013
Batista 1 7 11 69 30 182 8 20 5 5
Congenital Defect Repair 524 497 548 600 577 681 494 628 762 390
Transmyocardial Laser Revascularization 1 13 61 148 194 652 1,521 1,479 1,763 865
Cardiac Trauma 73 97 97 134 98 233 95 114 180 60
Cardiac Transplant 439 497 575 657 558 699 450 480 615 268
AICD - Automatic Implanted Cardioverter 1,087 993 583 604 330 363 215 208 288 132
Defibrillator
Aortic Aneurysm 2,272 3,152 3,882 4,358 4,236 3,905 3,580 3,949 5,080 2,328
Carotid Endarterectomy 1,450 2,400 2,790 3,106 2,778 2,439 2,047 2,317 2,482 990
Other Vascular 1,146 1,505 1,692 1,624 1,372 1,347 1,124 1,374 1,399 580
Other Thoracic 1,463 1,752 1,939 1,915 1,541 1,529 1,383 1,655 1,858 751
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