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The STS AVR+CABG composite score: a report of the STS Quality Measurement Task Force.

Publication ,  Journal Article
Shahian, DM; He, X; Jacobs, JP; Rankin, JS; Welke, KF; Edwards, FH; Filardo, G; Fazzalari, FL; Furnary, A; Kurlansky, PA; Brennan, JM ...
Published in: Ann Thorac Surg
May 2014

BACKGROUND: The Society of Thoracic Surgeons (STS) is developing a portfolio of composite performance measures for the most commonly performed adult cardiac procedures. This manuscript describes the third composite measure in this series, aortic valve replacement (AVR) combined with coronary artery bypass grafting surgery (CABG). METHODS: We identified all patients in the STS Adult Cardiac Surgery Database who underwent AVR+CABG during recent 3-year (July 1, 2009, through June 30, 2012) and 5-year (July 1, 2007, through June 30, 2012) periods. Variables from the STS risk model for AVR+CABG were used to adjust morbidity and mortality outcomes. Evidence for internal mammary artery use in AVR+CABG was examined. We compared composite measures constructed using 3 or 5 years of outcomes with Bayesian credible intervals of 90%, 95%, or 98%. The final STS AVR+CABG composite performance measure is based on 3 years of data and 95% credible intervals. It includes risk-adjusted mortality and morbidity but not internal mammary artery use. RESULTS: Median composite score is 91.0% (interquartile range, 89.5% to 92.2%). There were 2.6% (24 of 915) one-star (lower performing) and 6.5% (59 of 915) three-star (higher performing) programs. Morbidity and mortality decrease monotonically as star ratings increase. The percentage of three-star programs increased substantially among programs that performed more than 150 procedures over 3 years compared with those performing 25 to 50 procedures (32.8% versus 1.6 %). Measure reliability was 0.51. CONCLUSIONS: The STS has developed a composite performance measure for AVR+CABG based on 3-year data samples and 95% credible intervals. This composite measure identified 9.1% of STS participants as having higher or lower than expected performance.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2014

Volume

97

Issue

5

Start / End Page

1604 / 1609

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery
  • Survival Analysis
  • Societies, Medical
  • Retrospective Studies
  • Respiratory System
  • Quality Assurance, Health Care
  • Prosthesis Failure
  • Postoperative Complications
  • Middle Aged
 

Citation

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Shahian, D. M., He, X., Jacobs, J. P., Rankin, J. S., Welke, K. F., Edwards, F. H., … O’Brien, S. M. (2014). The STS AVR+CABG composite score: a report of the STS Quality Measurement Task Force. Ann Thorac Surg, 97(5), 1604–1609. https://doi.org/10.1016/j.athoracsur.2013.10.114
Shahian, David M., Xia He, Jeffrey P. Jacobs, J Scott Rankin, Karl F. Welke, Fred H. Edwards, Giovanni Filardo, et al. “The STS AVR+CABG composite score: a report of the STS Quality Measurement Task Force.Ann Thorac Surg 97, no. 5 (May 2014): 1604–9. https://doi.org/10.1016/j.athoracsur.2013.10.114.
Shahian DM, He X, Jacobs JP, Rankin JS, Welke KF, Edwards FH, et al. The STS AVR+CABG composite score: a report of the STS Quality Measurement Task Force. Ann Thorac Surg. 2014 May;97(5):1604–9.
Shahian, David M., et al. “The STS AVR+CABG composite score: a report of the STS Quality Measurement Task Force.Ann Thorac Surg, vol. 97, no. 5, May 2014, pp. 1604–09. Pubmed, doi:10.1016/j.athoracsur.2013.10.114.
Shahian DM, He X, Jacobs JP, Rankin JS, Welke KF, Edwards FH, Filardo G, Fazzalari FL, Furnary A, Kurlansky PA, Brennan JM, Badhwar V, O’Brien SM. The STS AVR+CABG composite score: a report of the STS Quality Measurement Task Force. Ann Thorac Surg. 2014 May;97(5):1604–1609.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2014

Volume

97

Issue

5

Start / End Page

1604 / 1609

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery
  • Survival Analysis
  • Societies, Medical
  • Retrospective Studies
  • Respiratory System
  • Quality Assurance, Health Care
  • Prosthesis Failure
  • Postoperative Complications
  • Middle Aged