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The Society of Thoracic Surgeons Isolated Aortic Valve Replacement (AVR) Composite Score: a report of the STS Quality Measurement Task Force.

Publication ,  Journal Article
Shahian, DM; He, X; Jacobs, JP; Rankin, JS; Welke, KF; Filardo, G; Shewan, CM; O'Brien, SM
Published in: Ann Thorac Surg
December 2012

BACKGROUND: Risk-standardized mortality rates provide a valuable but incomplete assessment of provider performance. Consequently, The Society of Thoracic Surgeons (STS) previously developed a multidimensional composite quality measure for coronary artery bypass grafting, the most frequently performed cardiac surgical procedure. The current study creates a similar composite measure for isolated aortic valve replacement (AVR). METHODS: Because there are few widely accepted process measures for AVR, the STS AVR composite score is based solely on outcomes, including risk-standardized mortality and any-or-none risk-standardized morbidity (occurrence of sternal infection, reoperation, stroke, renal failure, or prolonged ventilation). Isolated AVR is performed less frequently than coronary artery bypass grafting, and 1 year of data provided inadequate sample sizes for profiling. Therefore, we investigated observation periods of 3 years (July 1, 2007, to June 30, 2010: 67,138 records, 2,082 deaths, and 11,962 morbidity events) and 5 years (July 1, 2005, to June 30, 2010: 101,269 records, 3,123 deaths, and 17,514 morbidity events). We also compared results using 90%, 95%, and 98% credible intervals, corresponding to 95%, 97.5%, and 99% Bayesian probabilities, to determine "star ratings." RESULTS: Differences between 3-year and 5-year results were small; the former was chosen because this time frame provides more current and relevant data. Using 3 years of data and 95% credible intervals, adjusted mortality and morbidity rates varied threefold from highest performing (3 stars) to lowest performing (1 star) programs. Approximately 3% of participants were 1-star, 6% were 3-star, and 91% were 2-star programs. CONCLUSIONS: STS has developed a composite mortality and morbidity outcomes measure for isolated AVR to be used in quality assessment, provider feedback, public reporting, and performance improvement.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

December 2012

Volume

94

Issue

6

Start / End Page

2166 / 2171

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery
  • Survival Rate
  • Societies, Medical
  • Risk Adjustment
  • Respiratory System
  • Reproducibility of Results
  • Quality Assurance, Health Care
  • Postoperative Complications
  • Morbidity
 

Citation

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ICMJE
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Shahian, D. M., He, X., Jacobs, J. P., Rankin, J. S., Welke, K. F., Filardo, G., … O’Brien, S. M. (2012). The Society of Thoracic Surgeons Isolated Aortic Valve Replacement (AVR) Composite Score: a report of the STS Quality Measurement Task Force. Ann Thorac Surg, 94(6), 2166–2171. https://doi.org/10.1016/j.athoracsur.2012.08.120
Shahian, David M., Xia He, Jeffrey P. Jacobs, J Scott Rankin, Karl F. Welke, Giovanni Filardo, Cynthia M. Shewan, and Sean M. O’Brien. “The Society of Thoracic Surgeons Isolated Aortic Valve Replacement (AVR) Composite Score: a report of the STS Quality Measurement Task Force.Ann Thorac Surg 94, no. 6 (December 2012): 2166–71. https://doi.org/10.1016/j.athoracsur.2012.08.120.
Shahian DM, He X, Jacobs JP, Rankin JS, Welke KF, Filardo G, et al. The Society of Thoracic Surgeons Isolated Aortic Valve Replacement (AVR) Composite Score: a report of the STS Quality Measurement Task Force. Ann Thorac Surg. 2012 Dec;94(6):2166–71.
Shahian, David M., et al. “The Society of Thoracic Surgeons Isolated Aortic Valve Replacement (AVR) Composite Score: a report of the STS Quality Measurement Task Force.Ann Thorac Surg, vol. 94, no. 6, Dec. 2012, pp. 2166–71. Pubmed, doi:10.1016/j.athoracsur.2012.08.120.
Shahian DM, He X, Jacobs JP, Rankin JS, Welke KF, Filardo G, Shewan CM, O’Brien SM. The Society of Thoracic Surgeons Isolated Aortic Valve Replacement (AVR) Composite Score: a report of the STS Quality Measurement Task Force. Ann Thorac Surg. 2012 Dec;94(6):2166–2171.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

December 2012

Volume

94

Issue

6

Start / End Page

2166 / 2171

Location

Netherlands

Related Subject Headings

  • United States
  • Thoracic Surgery
  • Survival Rate
  • Societies, Medical
  • Risk Adjustment
  • Respiratory System
  • Reproducibility of Results
  • Quality Assurance, Health Care
  • Postoperative Complications
  • Morbidity