Scholars@Duke
Sean Michael O'Brien

Sean Michael O'Brien

Associate Professor of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Biostatistics
sean.m.obrien@duke.edu
Duke Box 3850, Durham, NC 27710
200 Morris Street, 7816 200 Morris, Durham, NC 27701
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Selected Publications

Outcomes of Isolated Tricuspid Valve Surgery: A Society of Thoracic Surgeons Analysis and Risk Model.

Journal Article Ann Thorac Surg · May 7, 2024 BACKGROUND: To provide patients and surgeons with clinically relevant information, The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database was queried to develop a risk model for isolated tricuspid valve (TV) operations. METHODS: All patients ... Full text Link to item Cite

Evaluating registry-based trial economics: Results from the STRESS clinical trial.

Journal Article Contemp Clin Trials Commun · April 2024 BACKGROUND: Registry-based trials have the potential to reduce randomized clinical trial (RCT) costs. However, observed cost differences also may be achieved through pragmatic trial designs. A systematic comparison of trial costs across different designs h ... Full text Link to item Cite

Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial.

Journal Article J Am Heart Assoc · March 5, 2024 BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chroni ... Full text Link to item Cite

Body Mass Index and Clinical and Health Status Outcomes in Chronic Coronary Disease and Advanced Kidney Disease in the ISCHEMIA-CKD Trial.

Journal Article Am J Med · February 2024 OBJECTIVE: This study aimed to assess whether an obesity paradox (lower event rates with higher body mass index [BMI]) exists in participants with advanced chronic kidney disease (CKD) and chronic coronary disease in the International Study of Comparative ... Full text Link to item Cite

Benchmarking Outcomes of Surgical Aortic Valve Replacement in Patients With Bicuspid Aortic Valves.

Journal Article Ann Thorac Surg · December 2023 BACKGROUND: The relative roles for transcatheter and surgical aortic valve replacement (SAVR) for bicuspid aortic valve (AV) stenosis are debated. This study analyzes the 5-year longitudinal outcomes of isolated SAVR in bicuspid vs tricuspid AV patients, p ... Full text Link to item Cite

Contemporary Relationship Between Hospital Volume and Outcomes in Congenital Heart Surgery.

Journal Article Ann Thorac Surg · December 2023 BACKGROUND: Studies examining the volume-outcome relationship in congenital heart surgery (CHS) are more than a decade old. Since then, mortality has declined, and case-mix adjustment has evolved. We determined the current relationship between hospital CHS ... Full text Link to item Cite

Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for Congenital Heart Disease: A Commentary on Recent Randomized Controlled Trials.

Journal Article Pediatr Crit Care Med · November 1, 2023 The recent NITRIC and STRESS trials demonstrate opportunities to perform pragmatic large randomized trials in congenital heart disease. We discuss lessons learnt from these trials which can inform future trial design and conduct in the field of pediatric h ... Full text Link to item Cite

Impact of Complete Revascularization in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · September 19, 2023 BACKGROUND: Anatomic complete revascularization (ACR) and functional complete revascularization (FCR) have been associated with reduced death and myocardial infarction (MI) in some prior studies. The impact of complete revascularization (CR) in patients un ... Full text Link to item Cite

Development of a Novel Society of Thoracic Surgeons Adult Congenital Mortality Risk Model.

Journal Article Ann Thorac Surg · August 2023 BACKGROUND: Operative mortality risk models for adults with congenital heart disease (ACHD) undergoing cardiac operations are essential, given the growing population of these patients, yet they are currently unavailable. Existing adult Society of Thoracic ... Full text Link to item Cite

Abatacept, Cenicriviroc, or Infliximab for Treatment of Adults Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial.

Journal Article JAMA · July 25, 2023 IMPORTANCE: Immune dysregulation contributes to poorer outcomes in COVID-19. OBJECTIVE: To investigate whether abatacept, cenicriviroc, or infliximab provides benefit when added to standard care for COVID-19 pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Ra ... Full text Open Access Link to item Cite

Complete Revascularization and Angina-Related Health Status in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · July 25, 2023 BACKGROUND: The impact of complete revascularization (CR) on angina-related health status (symptoms, function, quality of life) in chronic coronary disease (CCD) has not been well studied. OBJECTIVES: Among patients with CCD randomized to invasive (INV) vs ... Full text Link to item Cite

Health Status and Clinical Outcomes in Older Adults With Chronic Coronary Disease: The ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · May 2, 2023 BACKGROUND: Whether initial invasive management in older vs younger adults with chronic coronary disease and moderate or severe ischemia improves health status or clinical outcomes is unknown. OBJECTIVES: The goal of this study was to examine the impact of ... Full text Link to item Cite

Optimal circulatory arrest temperature for aortic hemiarch replacement with antegrade brain perfusion.

Conference J Thorac Cardiovasc Surg · May 2023 OBJECTIVE: This study sought to identify the optimal temperature for moderate hypothermic circulatory arrest in patients undergoing elective hemiarch replacement with antegrade brain perfusion. METHODS: The Society of Thoracic Surgeons adult cardiac surger ... Full text Link to item Cite

Modeling the Association of Volume vs Composite Outcome Thresholds With Outcomes and Access to Transcatheter Aortic Valve Implantation in the US.

Journal Article JAMA Cardiol · May 1, 2023 IMPORTANCE: Professional societies and the Centers for Medicare & Medicaid Services suggest volume thresholds to ensure quality in transcatheter aortic valve implantation (TAVI). OBJECTIVE: To model the association of volume thresholds vs spoke-and-hub imp ... Full text Link to item Cite

Perioperative Anemia and Transfusions and Late Mortality in Coronary Artery Bypass Patients.

Journal Article Ann Thorac Surg · March 2023 BACKGROUND: Perioperative anemia and transfusions are associated with adverse operative outcomes after coronary artery bypass graft surgery (CABG). Their individual association with long-term outcomes is unclear. METHODS: Patients aged 65 years and older w ... Full text Link to item Cite

Risk of Surgical Mitral Valve Repair for Primary Mitral Regurgitation.

Journal Article Ann Thorac Surg · March 2023 BACKGROUND: Risk estimation for surgical intervention is an essential component of heart team shared decision-making. However, current mitral valve (MV) surgery risk models used in practice lack etiologic or procedural specificity. The purpose of this stud ... Full text Link to item Cite

Risk of Surgical Mitral Valve Repair for Primary Mitral Regurgitation.

Journal Article J Am Coll Cardiol · February 21, 2023 BACKGROUND: Risk estimation for surgical intervention is an essential component of heart team shared decision-making. However, current mitral valve (MV) surgery risk models used in practice lack etiologic or procedural specificity. OBJECTIVES: The purpose ... Full text Link to item Cite

Comparing Consumer-Directed Hospital Rankings With STS Adult Cardiac Surgery Database Outcomes.

Journal Article Ann Thorac Surg · February 2023 BACKGROUND: Public interest in stratifying hospital performance has led to the proliferation of commercial, consumer-oriented hospital rankings. In cardiac surgery, little is known about how these rankings correlate with clinical registry quality ratings. ... Full text Link to item Cite

Outcomes of Isolated Tricuspid Valve Surgery: A Society of Thoracic Surgeons Analysis and Risk Model.

Journal Article Ann Thorac Surg · May 7, 2024 BACKGROUND: To provide patients and surgeons with clinically relevant information, The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database was queried to develop a risk model for isolated tricuspid valve (TV) operations. METHODS: All patients ... Full text Link to item Cite

Evaluating registry-based trial economics: Results from the STRESS clinical trial.

Journal Article Contemp Clin Trials Commun · April 2024 BACKGROUND: Registry-based trials have the potential to reduce randomized clinical trial (RCT) costs. However, observed cost differences also may be achieved through pragmatic trial designs. A systematic comparison of trial costs across different designs h ... Full text Link to item Cite

Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial.

Journal Article J Am Heart Assoc · March 5, 2024 BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chroni ... Full text Link to item Cite

Body Mass Index and Clinical and Health Status Outcomes in Chronic Coronary Disease and Advanced Kidney Disease in the ISCHEMIA-CKD Trial.

Journal Article Am J Med · February 2024 OBJECTIVE: This study aimed to assess whether an obesity paradox (lower event rates with higher body mass index [BMI]) exists in participants with advanced chronic kidney disease (CKD) and chronic coronary disease in the International Study of Comparative ... Full text Link to item Cite

Benchmarking Outcomes of Surgical Aortic Valve Replacement in Patients With Bicuspid Aortic Valves.

Journal Article Ann Thorac Surg · December 2023 BACKGROUND: The relative roles for transcatheter and surgical aortic valve replacement (SAVR) for bicuspid aortic valve (AV) stenosis are debated. This study analyzes the 5-year longitudinal outcomes of isolated SAVR in bicuspid vs tricuspid AV patients, p ... Full text Link to item Cite

Contemporary Relationship Between Hospital Volume and Outcomes in Congenital Heart Surgery.

Journal Article Ann Thorac Surg · December 2023 BACKGROUND: Studies examining the volume-outcome relationship in congenital heart surgery (CHS) are more than a decade old. Since then, mortality has declined, and case-mix adjustment has evolved. We determined the current relationship between hospital CHS ... Full text Link to item Cite

Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for Congenital Heart Disease: A Commentary on Recent Randomized Controlled Trials.

Journal Article Pediatr Crit Care Med · November 1, 2023 The recent NITRIC and STRESS trials demonstrate opportunities to perform pragmatic large randomized trials in congenital heart disease. We discuss lessons learnt from these trials which can inform future trial design and conduct in the field of pediatric h ... Full text Link to item Cite

Impact of Complete Revascularization in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · September 19, 2023 BACKGROUND: Anatomic complete revascularization (ACR) and functional complete revascularization (FCR) have been associated with reduced death and myocardial infarction (MI) in some prior studies. The impact of complete revascularization (CR) in patients un ... Full text Link to item Cite

Development of a Novel Society of Thoracic Surgeons Adult Congenital Mortality Risk Model.

Journal Article Ann Thorac Surg · August 2023 BACKGROUND: Operative mortality risk models for adults with congenital heart disease (ACHD) undergoing cardiac operations are essential, given the growing population of these patients, yet they are currently unavailable. Existing adult Society of Thoracic ... Full text Link to item Cite

Abatacept, Cenicriviroc, or Infliximab for Treatment of Adults Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial.

Journal Article JAMA · July 25, 2023 IMPORTANCE: Immune dysregulation contributes to poorer outcomes in COVID-19. OBJECTIVE: To investigate whether abatacept, cenicriviroc, or infliximab provides benefit when added to standard care for COVID-19 pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Ra ... Full text Open Access Link to item Cite

Complete Revascularization and Angina-Related Health Status in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · July 25, 2023 BACKGROUND: The impact of complete revascularization (CR) on angina-related health status (symptoms, function, quality of life) in chronic coronary disease (CCD) has not been well studied. OBJECTIVES: Among patients with CCD randomized to invasive (INV) vs ... Full text Link to item Cite

Health Status and Clinical Outcomes in Older Adults With Chronic Coronary Disease: The ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · May 2, 2023 BACKGROUND: Whether initial invasive management in older vs younger adults with chronic coronary disease and moderate or severe ischemia improves health status or clinical outcomes is unknown. OBJECTIVES: The goal of this study was to examine the impact of ... Full text Link to item Cite

Optimal circulatory arrest temperature for aortic hemiarch replacement with antegrade brain perfusion.

Conference J Thorac Cardiovasc Surg · May 2023 OBJECTIVE: This study sought to identify the optimal temperature for moderate hypothermic circulatory arrest in patients undergoing elective hemiarch replacement with antegrade brain perfusion. METHODS: The Society of Thoracic Surgeons adult cardiac surger ... Full text Link to item Cite

Modeling the Association of Volume vs Composite Outcome Thresholds With Outcomes and Access to Transcatheter Aortic Valve Implantation in the US.

Journal Article JAMA Cardiol · May 1, 2023 IMPORTANCE: Professional societies and the Centers for Medicare & Medicaid Services suggest volume thresholds to ensure quality in transcatheter aortic valve implantation (TAVI). OBJECTIVE: To model the association of volume thresholds vs spoke-and-hub imp ... Full text Link to item Cite

Perioperative Anemia and Transfusions and Late Mortality in Coronary Artery Bypass Patients.

Journal Article Ann Thorac Surg · March 2023 BACKGROUND: Perioperative anemia and transfusions are associated with adverse operative outcomes after coronary artery bypass graft surgery (CABG). Their individual association with long-term outcomes is unclear. METHODS: Patients aged 65 years and older w ... Full text Link to item Cite

Risk of Surgical Mitral Valve Repair for Primary Mitral Regurgitation.

Journal Article Ann Thorac Surg · March 2023 BACKGROUND: Risk estimation for surgical intervention is an essential component of heart team shared decision-making. However, current mitral valve (MV) surgery risk models used in practice lack etiologic or procedural specificity. The purpose of this stud ... Full text Link to item Cite

Risk of Surgical Mitral Valve Repair for Primary Mitral Regurgitation.

Journal Article J Am Coll Cardiol · February 21, 2023 BACKGROUND: Risk estimation for surgical intervention is an essential component of heart team shared decision-making. However, current mitral valve (MV) surgery risk models used in practice lack etiologic or procedural specificity. OBJECTIVES: The purpose ... Full text Link to item Cite

Comparing Consumer-Directed Hospital Rankings With STS Adult Cardiac Surgery Database Outcomes.

Journal Article Ann Thorac Surg · February 2023 BACKGROUND: Public interest in stratifying hospital performance has led to the proliferation of commercial, consumer-oriented hospital rankings. In cardiac surgery, little is known about how these rankings correlate with clinical registry quality ratings. ... Full text Link to item Cite

Survival After Invasive or Conservative Management of Stable Coronary Disease.

Journal Article Circulation · January 3, 2023 BACKGROUND: The ISCHEMIA trial (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) compared an initial invasive versus an initial conservative management strategy for patients with chronic coronary disease and mod ... Full text Link to item Cite

Ischemia With Nonobstructive Coronary Arteries: Insights From the ISCHEMIA Trial.

Journal Article JACC Cardiovasc Imaging · January 2023 BACKGROUND: Ischemia with nonobstructive coronary arteries (INOCA) is common clinically, particularly among women, but its prevalence among patients with at least moderate ischemia and the relationship between ischemia severity and non-obstructive atherosc ... Full text Link to item Cite

Initial Thoracic Endovascular Aortic Repair vs Medical Therapy for Acute Uncomplicated Type B Aortic Dissection.

Journal Article JAMA Cardiol · January 1, 2023 IMPORTANCE: Thoracic endovascular aortic repair (TEVAR) has increasingly been used for uncomplicated type B aortic dissection (uTBAD) despite limited supporting data. OBJECTIVE: To assess whether initial TEVAR following uTBAD is associated with reduced mor ... Full text Link to item Cite

Cause-Specific Mortality in Patients With Advanced Chronic Kidney Disease in the ISCHEMIA-CKD Trial.

Journal Article JACC. Cardiovascular interventions · January 2023 BackgroundIn ISCHEMIA-CKD, 777 patients with advanced chronic kidney disease and chronic coronary disease had similar all-cause mortality with either an initial invasive or conservative strategy (27.2% vs 27.8%, respectively).ObjectivesTh ... Full text Cite

Methylprednisolone for Heart Surgery in Infants - A Randomized, Controlled Trial.

Journal Article N Engl J Med · December 8, 2022 BACKGROUND: Although perioperative prophylactic glucocorticoids have been used for decades, whether they improve outcomes in infants after heart surgery with cardiopulmonary bypass is unknown. METHODS: We conducted a multicenter, prospective, randomized, p ... Full text Link to item Cite

Aortic Prosthetic Valve Endocarditis: Analysis of The Society of Thoracic Surgeons Database.

Journal Article Ann Thorac Surg · December 2022 BACKGROUND: This study sought to characterize the current US experience of aortic prosthetic valve endocarditis (PVE) compared with native valve endocarditis (NVE). METHODS: The Society of Thoracic Surgeons Database was queried for entries of active aortic ... Full text Link to item Cite

ISCHEMIA-EXTEND studies: Rationale and design.

Journal Article Am Heart J · December 2022 BACKGROUND: The ISCHEMIA and the ISCHEMIA-CKD trials found no statistical difference in the primary clinical endpoint between initial invasive management and initial conservative management of patients with chronic coronary disease and moderate to severe i ... Full text Link to item Cite

Guideline-Directed Medical Therapy Attainment and Outcomes in Dialysis-Requiring Versus Nondialysis Chronic Kidney Disease in the ISCHEMIA-CKD Trial.

Journal Article Circ Cardiovasc Qual Outcomes · October 2022 BACKGROUND: Patients with chronic kidney disease (CKD) on dialysis (CKD G5D) have worse cardiovascular outcomes than patients with advanced nondialysis CKD (CKD G4-5: estimated glomerular filtration rate <30 mL/[min·1.73m2]). Our objective was to evaluate ... Full text Link to item Cite

Abatacept for Treatment of Adults Hospitalized with Moderate or Severe Covid-19.

Journal Article medRxiv · September 26, 2022 BACKGROUND: We investigated whether abatacept, a selective costimulation modulator, provides additional benefit when added to standard-of-care for patients hospitalized with Covid-19. METHODS: We conducted a master protocol to investigate immunomodulators ... Full text Link to item Cite

The STS Participant-Level, Multiprocedural Composite Measure for Adult Cardiac Surgery.

Journal Article Ann Thorac Surg · August 2022 BACKGROUND: Composite performance measures for the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database participants (typically hospital departments or practice groups) are currently available only for individual procedures. To assess overall ... Full text Link to item Cite

Strategies for Mechanical Right Ventricular Support During Left Ventricular Assist Device Implant.

Journal Article Ann Thorac Surg · August 2022 BACKGROUND: Refractory right ventricular failure at the time of left ventricular assist device implantation requires treatment with supplemental mechanical circulatory support. However, the optimal strategy for support remains unknown. METHODS: All patient ... Full text Link to item Cite

Clinical and Quality-of-Life Outcomes Following Invasive vs Conservative Treatment of Patients With Chronic Coronary Disease Across the Spectrum of Kidney Function.

Journal Article JAMA Cardiol · August 1, 2022 IMPORTANCE: Prior trials of invasive vs conservative management of chronic coronary disease (CCD) have not enrolled patients with severe chronic kidney disease (CKD). As such, outcomes across kidney function are not well characterized. OBJECTIVES: To evalu ... Full text Link to item Cite

Anticoagulation in new-onset postoperative atrial fibrillation: An analysis from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article Heart Rhythm O2 · August 2022 BACKGROUND: New-onset postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery and is associated with increased long-term stroke and mortality. Anticoagulation has been suggested as a potential therapy, but data on saf ... Full text Link to item Cite

Causes of cardiovascular and noncardiovascular death in the ISCHEMIA trial.

Conference Am Heart J · June 2022 BACKGROUND: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial demonstrated no overall difference in the composite primary endpoint and the secondary endpoints of cardiovascular (CV) death/myocardial infa ... Full text Link to item Cite

Failure to Rescue: A New Society of Thoracic Surgeons Quality Metric for Cardiac Surgery.

Journal Article Ann Thorac Surg · June 2022 BACKGROUND: Failure to rescue (FTR) focuses on the ability to prevent death among patients who have postoperative complications. The Society of Thoracic Surgeons (STS) Quality Measurement Task Force has developed a new, risk-adjusted FTR quality metric for ... Full text Link to item Cite

Sex Differences in Coronary Artery Bypass Grafting Techniques: A Society of Thoracic Surgeons Database Analysis.

Journal Article Ann Thorac Surg · June 2022 BACKGROUND: Female patients with coronary artery disease have inferior outcomes compared with male patients, including higher mortality after coronary artery bypass graft surgery (CABG). We aimed to evaluate the association of female sex with the use of gu ... Full text Link to item Cite

The Society of Thoracic Surgeons Coronary Artery Bypass Graft Composite Measure: 2021 Methodology Update.

Journal Article Ann Thorac Surg · June 2022 BACKGROUND: The Society of Thoracic Surgeons (STS) original coronary artery bypass graft surgery (CABG) composite measure uses a 1-year analytic cohort and 98% credible intervals (CrI) to classify better than expected (3-star) performance or worse than exp ... Full text Link to item Cite

Current Penetration, Completeness, and Representativeness of The Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article Ann Thorac Surg · May 2022 BACKGROUND: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) is the largest cardiac surgical database in the world. Linked data from STS ACSD and the Centers for Medicare and Medicaid Services (CMS) database were used to determi ... Full text Link to item Cite

COVID-19 Trials: Who Participates and Who Benefits?

Journal Article South Med J · April 2022 OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately afflicted vulnerable populations. Older adults, particularly residents of nursing facilities, represent a small percentage of the population but account for 40% of mortalit ... Full text Open Access Link to item Cite

Outcomes With Intermediate Left Main Disease: Analysis From the ISCHEMIA Trial.

Journal Article Circ Cardiovasc Interv · April 2022 BACKGROUND: Patients with significant (≥50%) left main disease (LMD) have a high risk of cardiovascular events, and guidelines recommend revascularization to improve survival. However, the impact of intermediate LMD (stenosis, 25%-49%) on outcomes is uncle ... Full text Link to item Cite

Evolving Cost-Quality Relationship in Pediatric Heart Surgery.

Journal Article Ann Thorac Surg · March 2022 BACKGROUND: For the more than 40,000 children in the United States undergoing congenital heart surgery annually, the relationship between hospital quality and costs remains unclear. Prior studies report conflicting results and clinical outcomes have contin ... Full text Link to item Cite

Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial.

Journal Article J Am Coll Cardiol · February 22, 2022 BACKGROUND: Detection of ≥50% diameter stenosis left main coronary artery disease (LMD) has prognostic and therapeutic implications. Noninvasive stress imaging or an exercise tolerance test (ETT) are the most common methods to detect obstructive coronary a ... Full text Link to item Cite

The Society of Thoracic Surgeons 2021 Adult Cardiac Surgery Risk Models for Multiple Valve Operations.

Journal Article Ann Thorac Surg · February 2022 BACKGROUND: The Society of Thoracic Surgeons (STS) Quality Measurement Task Force has developed risk models and composite performance measures for isolated coronary artery bypass grafting (CABG), isolated aortic valve replacement (AVR), isolated mitral val ... Full text Link to item Cite

Effects of initial invasive vs. initial conservative treatment strategies on recurrent and total cardiovascular events in the ISCHEMIA trial.

Journal Article Eur Heart J · January 13, 2022 AIMS: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial prespecified an analysis to determine whether accounting for recurrent cardiovascular events in addition to first events modified unders ... Full text Link to item Cite

Predictors of outcome in the ISCHEMIA-CKD trial: Anatomy versus ischemia.

Journal Article Am Heart J · January 2022 BACKGROUND: The ISCHEMIA-CKD (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease) trial found no advantage to an invasive strategy compared to conservative management in reducing all-cause de ... Full text Link to item Cite

Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity.

Journal Article Circulation · September 28, 2021 BACKGROUND: The ISCHEMIA trial (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) postulated that patients with stable coronary artery disease (CAD) and moderate or severe ischemia would benefit from revasculariz ... Full text Link to item Cite

Comparison of Days Alive Out of Hospital With Initial Invasive vs Conservative Management: A Prespecified Analysis of the ISCHEMIA Trial.

Journal Article JAMA cardiology · September 2021 ImportanceTraditional time-to-event analyses rate events occurring early as more important than later events, even if later events are more severe, eg, death. Days alive out of hospital (DAOH) adds a patient-focused perspective beyond trial end po ... Full text Cite

Composite Metric for Benchmarking Site Performance in Transcatheter Aortic Valve Replacement: Results From the STS/ACC TVT Registry.

Journal Article Circulation · July 20, 2021 BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a transformative therapy for aortic stenosis. Despite rapid improvements in technology and techniques, serious complications remain relatively common and are not well described by single outcome ... Full text Link to item Cite

Transesophageal Echocardiography in Patients Undergoing Coronary Artery Bypass Graft Surgery.

Journal Article J Am Coll Cardiol · July 13, 2021 BACKGROUND: The impact of utilization of intraoperative transesophageal echocardiography (TEE) at the time of isolated coronary artery bypass grafting (CABG) on clinical decision making and associated outcomes is not well understood. OBJECTIVES: The purpos ... Full text Link to item Cite

CT Angiography Followed by Invasive Angiography in Patients With Moderate or Severe Ischemia-Insights From the ISCHEMIA Trial.

Journal Article JACC Cardiovasc Imaging · July 2021 OBJECTIVES: This study aimed to examine the concordance of coronary computed tomographic angiography (CCTA) assessment of coronary anatomy and invasive coronary angiography (ICA) as the reference standard in patients enrolled in the ISCHEMIA (International ... Full text Link to item Cite

Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials.

Journal Article Nat Commun · April 15, 2021 Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine a ... Full text Open Access Link to item Cite

Myocardial Infarction in the ISCHEMIA Trial: Impact of Different Definitions on Incidence, Prognosis, and Treatment Comparisons.

Journal Article Circulation · February 23, 2021 BACKGROUND: In the ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), an initial invasive strategy did not significantly reduce rates of cardiovascular events or all-cause mortality in comparison ... Full text Link to item Cite

National Variation in Congenital Heart Surgery Outcomes.

Journal Article Circulation · October 6, 2020 BACKGROUND: Optimal strategies to improve national congenital heart surgery outcomes and reduce variability across hospitals remain unclear. Many policy and quality improvement efforts have focused primarily on higher-risk patients and mortality alone. Imp ... Full text Link to item Cite

Estimating Resource Utilization in Congenital Heart Surgery.

Journal Article Ann Thorac Surg · September 2020 BACKGROUND: Optimal methods to assess resource utilization in congenital heart surgery remain unclear. We compared traditional cost-to-charge ratio methods with newer standardized cost methods that aim to more directly assess resources consumed. METHODS: C ... Full text Link to item Cite

Overcoming underpowering: Trial simulations and a global rank end point to optimize clinical trials in children with heart disease.

Journal Article Am Heart J · August 2020 BACKGROUND: Randomized controlled trials (RCTs) in children with heart disease are challenging and therefore infrequently performed. We sought to improve feasibility of perioperative RCTs for this patient cohort using data from a large, multicenter clinica ... Full text Link to item Cite

Association of Sex With Severity of Coronary Artery Disease, Ischemia, and Symptom Burden in Patients With Moderate or Severe Ischemia: Secondary Analysis of the ISCHEMIA Randomized Clinical Trial.

Journal Article JAMA Cardiol · July 1, 2020 IMPORTANCE: While many features of stable ischemic heart disease vary by sex, differences in ischemia, coronary anatomy, and symptoms by sex have not been investigated among patients with moderate or severe ischemia. The enrolled ISCHEMIA trial cohort that ... Full text Link to item Cite

Management of Coronary Disease in Patients with Advanced Kidney Disease.

Journal Article N Engl J Med · April 23, 2020 BACKGROUND: Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS: We randomly assigned 777 patients with advanced kidney dise ... Full text Link to item Cite

Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease.

Journal Article N Engl J Med · April 23, 2020 BACKGROUND: In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared w ... Full text Link to item Cite

Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease.

Journal Article N Engl J Med · April 9, 2020 BACKGROUND: In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial ... Full text Link to item Cite

Initial Invasive or Conservative Strategy for Stable Coronary Disease.

Journal Article N Engl J Med · April 9, 2020 BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. M ... Full text Link to item Cite

Association of postoperative complications and outcomes following coronary artery bypass grafting.

Journal Article Am Heart J · April 2020 BACKGROUND: The long-term effects of postoperative complications following coronary artery bypass grafting (CABG) are unknown. METHODS: Medicare-linked records from the Society of Thoracic Surgeons Adult Cardiac Surgery Database were queried for isolated C ... Full text Link to item Cite

Rationale and design of the STeroids to REduce Systemic inflammation after infant heart Surgery (STRESS) trial.

Journal Article Am Heart J · February 2020 For decades, physicians have administered corticosteroids in the perioperative period to infants undergoing heart surgery with cardiopulmonary bypass (CPB) to reduce the postoperative systemic inflammatory response to CPB. Some question this practice becau ... Full text Link to item Cite

Claims-based cardiovascular outcome identification for clinical research: Results from 7 large randomized cardiovascular clinical trials.

Journal Article Am Heart J · December 2019 BACKGROUND: Medicare insurance claims may provide an efficient means to ascertain follow-up of older participants in clinical research. We sought to determine the accuracy and completeness of claims- versus site-based follow-up with clinical event committe ... Full text Link to item Cite

Baseline Predictors of Low-Density Lipoprotein Cholesterol and Systolic Blood Pressure Goal Attainment After 1 Year in the ISCHEMIA Trial.

Journal Article Circ Cardiovasc Qual Outcomes · November 2019 BACKGROUND: Risk factor control is the cornerstone of managing stable ischemic heart disease but is often not achieved. Predictors of risk factor control in a randomized clinical trial have not been described. METHODS AND RESULTS: The ISCHEMIA trial (Inter ... Full text Link to item Cite

Variation in Gastrostomy Tube Placement in Premature Infants in the United States.

Journal Article Am J Perinatol · October 2019 OBJECTIVE: To describe the variation in surgical gastrostomy tube (SGT) placement in premature infants among neonatal intensive care units (NICUs) in the United States. STUDY DESIGN: We identified 8,781 premature infants discharged from 114 NICUs in the Pe ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2019 Update on Research.

Journal Article Ann Thorac Surg · September 2019 As the largest congenital and pediatric cardiac surgical clinical data registry in the world, The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) serves as a platform for reporting of outcomes and for quality improvement. In addit ... Full text Link to item Cite

Refining The Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model With Enhanced Risk Adjustment for Chromosomal Abnormalities, Syndromes, and Noncardiac Congenital Anatomic Abnormalities.

Journal Article Ann Thorac Surg · August 2019 BACKGROUND: The Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model adjusts not only for procedure and age group pairings but also for additional patient factors, including the binary presence or absence of a chromosomal abn ... Full text Link to item Cite

Patient perspectives on the linkage of health data for research: Insights from an online patient community questionnaire.

Journal Article Int J Med Inform · July 2019 OBJECTIVE: To examine the patient perspective on the risks and benefits of linking existing data sources for research. MATERIALS AND METHODS: Between December 2015 and February 2016, we fielded a questionnaire in PatientsLikeMe, an online patient community ... Full text Link to item Cite

Transcatheter Aortic Valve Replacement in Patients With End-Stage Renal Disease.

Journal Article J Am Coll Cardiol · June 11, 2019 BACKGROUND: In patients with end-stage renal disease (ESRD), surgical aortic valve replacement is associated with higher early and late mortality, and adverse outcomes compared with patients without renal disease. Transcatheter aortic valve replacement (TA ... Full text Link to item Cite

Development and Application of a Risk Prediction Model for In-Hospital Stroke After Transcatheter Aortic Valve Replacement: A Report From The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal Article Ann Thorac Surg · April 2019 BACKGROUND: Stroke is a serious complication after transcatheter aortic valve replacement (TAVR), yet predictive models are not available. A new risk model for in-hospital stroke after TAVR was developed and used to estimate site-specific performance. METH ... Full text Link to item Cite

Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial.

Journal Article JAMA Cardiol · March 1, 2019 IMPORTANCE: It is unknown whether coronary revascularization, when added to optimal medical therapy, improves prognosis in patients with stable ischemic heart disease (SIHD) at increased risk of cardiovascular events owing to moderate or severe ischemia. O ... Full text Link to item Cite

Development of a Congenital Heart Surgery Composite Quality Metric: Part 2-Analytic Methods.

Journal Article Ann Thorac Surg · February 2019 BACKGROUND: We describe the statistical methods and results related to development of the first congenital heart surgery composite quality measure. METHODS: The composite measure was developed using The Society of Thoracic Surgeons Congenital Heart Surgery ... Full text Link to item Cite

Development of a Congenital Heart Surgery Composite Quality Metric: Part 1-Conceptual Framework.

Journal Article Ann Thorac Surg · February 2019 BACKGROUND: Current pediatric and congenital heart surgery quality measures focus on operative mortality, and numerous stakeholders are interested in more comprehensive measures. This report describes the background, rationale, and conceptual framework rel ... Full text Link to item Cite

The Impact of Mitral Disease Etiology on Operative Mortality After Mitral Valve Operations.

Journal Article Ann Thorac Surg · November 2018 BACKGROUND: The pathoetiology of mitral regurgitation (MR) has been suggested as a mediator of outcomes after mitral valve (MV) operations, particularly in ischemic functional mitral regurgitation (IMR). This study examined the independent association of M ... Full text Link to item Cite

International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease (ISCHEMIA-CKD): Rationale and design.

Journal Article Am Heart J · November 2018 BACKGROUND: Patients with chronic kidney disease (CKD) and stable ischemic heart disease are at markedly increased risk of cardiovascular events. Prior trials comparing a strategy of optimal medical therapy (OMT) with or without revascularization have larg ... Full text Link to item Cite

National Benchmarks for Proportions of Patients Receiving Blood Transfusions During Pediatric and Congenital Heart Surgery: An Analysis of the STS Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · October 2018 BACKGROUND: To determine national benchmarks and assess variability across centers, The Society of Thoracic Surgeons Congenital Heart Surgery Database was analyzed to document proportions of patients receiving intraoperative transfusion of packed red blood ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2018 Update on Research.

Journal Article Ann Thorac Surg · September 2018 The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) is the largest congenital and pediatric cardiac surgical clinical data registry in the world. The most recent biannual feedback report to participants includes analysis of data s ... Full text Link to item Cite

The Incidence and Consequence of Prosthesis-Patient Mismatch After Surgical Aortic Valve Replacement.

Journal Article Ann Thorac Surg · July 2018 BACKGROUND: The goal of this study was to determine the relationship of prosthesis-patient mismatch (PPM) with long-term survival and to assess whether growing concern about PPM has resulted in a decreased incidence over time. METHODS: Using The Society of ... Full text Link to item Cite

International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design.

Journal Article Am Heart J · July 2018 BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only ... Full text Link to item Cite

Single- Versus Multicenter Surgeons' Risk-Adjusted Coronary Artery Bypass Graft Procedural Outcomes.

Journal Article Ann Thorac Surg · May 2018 BACKGROUND: Since 2010, 460+ hospital mergers have occurred in the United States, rerouting historical coronary artery bypass graft (CABG) referral patterns. The goals of this study were: (1) to compare risk-adjusted CABG outcomes between single-center ver ... Full text Link to item Cite

The Society of Thoracic Surgeons 2018 Adult Cardiac Surgery Risk Models: Part 2-Statistical Methods and Results.

Journal Article Ann Thorac Surg · May 2018 BACKGROUND: The Society of Thoracic Surgeons (STS) uses statistical models to create risk-adjusted performance metrics for Adult Cardiac Surgery Database (ACSD) participants. Because of temporal changes in patient characteristics and outcomes, evolution of ... Full text Link to item Cite

The Society of Thoracic Surgeons 2018 Adult Cardiac Surgery Risk Models: Part 1-Background, Design Considerations, and Model Development.

Journal Article Ann Thorac Surg · May 2018 BACKGROUND: The last published version of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) risk models were developed in 2008 based on patient data from 2002 to 2006 and have been periodically recalibrated. In response to evolvi ... Full text Link to item Cite

ISCHEMIA: Establishing the Primary End Point.

Journal Article Circ Cardiovasc Qual Outcomes · May 2018 Full text Link to item Cite

Operative Outcomes of Multiple-Arterial Versus Single-Arterial Coronary Bypass Grafting.

Journal Article Ann Thorac Surg · April 2018 BACKGROUND: More than 90% of coronary artery bypass grafting (CABG) is performed with a single-arterial bypass graft (SABG), based on the left internal thoracic artery (ITA) with supplemental vein grafts. This practice, often justified by safety concerns w ... Full text Link to item Cite

Inclusion of Functional Status Measures in the Risk Adjustment of 30-Day Mortality After Transcatheter Aortic Valve Replacement: A Report From the Society of Thoracic Surgeons/American College of Cardiology TVT Registry.

Journal Article JACC Cardiovasc Interv · March 26, 2018 OBJECTIVES: The aim of this study was to develop and validate a risk adjustment model for 30-day mortality after transcatheter aortic valve replacement (TAVR) that accounted for both standard clinical factors and pre-procedural health status and frailty. B ... Full text Link to item Cite

How well does early-career investigators' cardiovascular outcomes research training align with funded outcomes research?

Journal Article Am Heart J · February 2018 BACKGROUND: Outcomes research training programs should prepare trainees to successfully compete for research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) outcomes research. ... Full text Link to item Cite

Training cardiovascular outcomes researchers: A survey of mentees and mentors to identify critical training gaps and needs.

Journal Article Am Heart J · February 2018 BACKGROUND: Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS: From April to November 2014, we surveyed mentees a ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2017 Update on Research.

Journal Article Ann Thorac Surg · September 2017 The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It contains data pertaining to more than 435,000 total operations. The most recent b ... Full text Link to item Cite

Transcatheter Versus Surgical Aortic Valve Replacement: Propensity-Matched Comparison.

Journal Article J Am Coll Cardiol · July 25, 2017 BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. ... Full text Link to item Cite

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2017 Update on Research.

Journal Article Ann Thorac Surg · July 2017 Containing more than 6 million cumulative operative records and accounting for 90% to 95% of adult cardiac surgery performed in the United States, The Society of Thoracic Surgeons Adult Cardiac Surgery Database is an invaluable resource for performance ass ... Full text Link to item Cite

The Society of Thoracic Surgeons Mitral Valve Repair/Replacement Plus Coronary Artery Bypass Grafting Composite Score: A Report of The Society of Thoracic Surgeons Quality Measurement Task Force.

Journal Article Ann Thorac Surg · May 2017 BACKGROUND: The Society of Thoracic Surgeons (STS) Quality Measurement Task Force has developed a composite performance measure for mitral repair/replacement (MVRR) with concomitant coronary artery bypass grafting (CABG). METHODS: Data were acquired from t ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2017 Update on Outcomes and Quality.

Journal Article Ann Thorac Surg · March 2017 The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analys ... Full text Link to item Cite

Performing Concomitant Tricuspid Valve Repair at the Time of Mitral Valve Operations Is Not Associated With Increased Operative Mortality.

Journal Article Ann Thorac Surg · February 2017 BACKGROUND: The performance of concomitant tricuspid valve repair (TVr) at the time of mitral valve repair or replacement (MVRR) has previously been associated with elevated short-term risk. Outcomes were assessed at incremental grades of tricuspid regurgi ... Full text Link to item Cite

The Society of Thoracic Surgeons National Database 2016 Annual Report.

Journal Article Ann Thorac Surg · December 2016 The art and science of outcomes analysis, quality improvement, and patient safety continue to evolve, and cardiothoracic surgery leads many of these advances. The Society of Thoracic Surgeons (STS) National Database is one of the principal reasons for this ... Full text Link to item Cite

Congenital Heart Surgery Case Mix Across North American Centers and Impact on Performance Assessment.

Journal Article Ann Thorac Surg · November 2016 BACKGROUND: Performance assessment in congenital heart surgery is challenging due to the wide heterogeneity of disease. We describe current case mix across centers, evaluate methodology inclusive of all cardiac operations versus the more homogeneous subset ... Full text Link to item Cite

Mortality Trends in Pediatric and Congenital Heart Surgery: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · October 2016 BACKGROUND: Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Data ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2016 Update on Research.

Journal Article Ann Thorac Surg · September 2016 The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) is the largest congenital and pediatric cardiac surgical clinical data registry in the world. With more than 400,000 total operations from nearly all centers performing pediatric ... Full text Link to item Cite

Variation in Hospital Risk-Adjusted Mortality Rates Following Transcatheter Aortic Valve Replacement in the United States: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal Article Circ Cardiovasc Qual Outcomes · September 2016 BACKGROUND: The use of transcatheter aortic valve replacement (TAVR) to treat aortic stenosis in the United States is growing, yet little is known about the variation in procedural outcomes in community practice. We developed a TAVR in-hospital mortality r ... Full text Link to item Cite

Failure to Rescue Rates After Coronary Artery Bypass Grafting: An Analysis From The Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article Ann Thorac Surg · August 2016 BACKGROUND: Failure to rescue (FTR) is increasingly recognized as an important quality indicator in surgery. The Society of Thoracic Surgeons National Database was used to develop FTR metrics and a predictive FTR model for coronary artery bypass grafting ( ... Full text Link to item Cite

The Society of Thoracic Surgeons Mitral Repair/Replacement Composite Score: A Report of The Society of Thoracic Surgeons Quality Measurement Task Force.

Journal Article Ann Thorac Surg · June 2016 BACKGROUND: The Society of Thoracic Surgeons (STS) Quality Measurement Task Force is developing a portfolio of composite performance measures for the most commonly performed procedures in adult cardiac surgery. We now describe the fourth in this series, th ... Full text Link to item Cite

Gait Speed and Operative Mortality in Older Adults Following Cardiac Surgery.

Journal Article JAMA Cardiol · June 1, 2016 IMPORTANCE: Prediction of operative risk is a critical step in decision making for cardiac surgery. Existing risk models may be improved by integrating a measure of frailty, such as 5-m gait speed, to better capture the heterogeneity of the older adult pop ... Full text Link to item Cite

Impact of Ejection Fraction and Aortic Valve Gradient on Outcomes of Transcatheter Aortic Valve Replacement.

Journal Article J Am Coll Cardiol · May 24, 2016 BACKGROUND: In patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR), studies have suggested that reduced left ventricular (LV) ejection fraction (LVEF) and low aortic valve gradient (AVG) are associated with worse long-ter ... Full text Link to item Cite

The Society of Thoracic Surgeons Composite Score for Rating Program Performance for Lobectomy for Lung Cancer.

Journal Article Ann Thorac Surg · April 2016 BACKGROUND: The Society of Thoracic Surgeons (STS) has developed multidimensional composite quality measures for common cardiac surgery procedures. This first composite measure for general thoracic surgery evaluates STS participant performance for lobectom ... Full text Link to item Cite

Development and Validation of a Risk Prediction Model for In-Hospital Mortality After Transcatheter Aortic Valve Replacement.

Journal Article JAMA Cardiol · April 1, 2016 IMPORTANCE: Patient selection for transcatheter aortic valve replacement (TAVR) should include assessment of the risks of TAVR compared with surgical aortic valve replacement (SAVR). Existing SAVR risk models accurately predict the risks for the population ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2016 Update on Outcomes and Quality.

Journal Article Ann Thorac Surg · March 2016 The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analys ... Full text Link to item Cite

Association of Hospital and Physician Characteristics and Care Processes With Racial Disparities in Procedural Outcomes Among Contemporary Patients Undergoing Coronary Artery Bypass Grafting Surgery.

Journal Article Circulation · January 12, 2016 BACKGROUND: Previous studies have reported that black patients undergoing coronary artery bypass surgery had worse outcomes than white patients, even after accounting for patient factors. The degree to which clinician, hospital, and care factors account fo ... Full text Link to item Cite

Penetration, Completeness, and Representativeness of The Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article Ann Thorac Surg · January 2016 BACKGROUND: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) has been successfully linked to the Centers for Medicare and Medicaid (CMS) Medicare database, thereby facilitating comparative effectiveness research and providing in ... Full text Link to item Cite

Introduction to the STS National Database Series: Outcomes Analysis, Quality Improvement, and Patient Safety.

Journal Article Ann Thorac Surg · December 2015 The Society of Thoracic Surgeons (STS) National Database is the foundation for most of the Society's quality, research, and patient safety activities. Beginning in January 2016 and repeating each year, The Annals of Thoracic Surgery will publish a monthly ... Full text Link to item Cite

Association of Patient-Reported Health Status With Long-Term Mortality After Transcatheter Aortic Valve Replacement: Report From the STS/ACC TVT Registry.

Journal Article Circ Cardiovasc Interv · December 2015 BACKGROUND: Although transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic stenosis, long-term mortality after TAVR remains high and challenging to predict. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a health status ... Full text Link to item Cite

The Society of Thoracic Surgeons Composite Measure of Individual Surgeon Performance for Adult Cardiac Surgery: A Report of The Society of Thoracic Surgeons Quality Measurement Task Force.

Journal Article Ann Thorac Surg · October 2015 BACKGROUND: Previous composite performance measures of The Society of Thoracic Surgeons (STS) were estimated at the STS participant level, typically a hospital or group practice. The STS Quality Measurement Task Force has now developed a multiprocedural, m ... Full text Link to item Cite

Impact of Patient Characteristics on Hospital-Level Outcomes Assessment in Congenital Heart Surgery.

Journal Article Ann Thorac Surg · September 2015 BACKGROUND: Accurate hospital outcome measures in congenital heart surgery are important to multiple initiatives. While methods have been developed to account for differences in procedural case-mix, characteristics patients bring into the operation that ma ... Full text Link to item Cite

The Society of Thoracic Surgeons voluntary public reporting initiative: the first 4 years.

Journal Article Ann Surg · September 2015 OBJECTIVES: To evaluate participant characteristics and outcomes during the first 4 years of the Society of Thoracic Surgeons (STS) public reporting program. BACKGROUND: This is the first detailed analysis of a national, voluntary, cardiac surgery public r ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model: Part 2-Clinical Application.

Journal Article Ann Thorac Surg · September 2015 BACKGROUND: The empirically derived 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model incorporates adjustment for procedure type and patient-specific factors. The purpose of this report is to describe this model and i ... Full text Link to item Cite

The Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model: Part 1-Statistical Methodology.

Journal Article Ann Thorac Surg · September 2015 BACKGROUND: This study's objective was to develop a risk model incorporating procedure type and patient factors to be used for case-mix adjustment in the analysis of hospital-specific operative mortality rates after congenital cardiac operations. METHODS: ... Full text Link to item Cite

Clinical outcomes at 1 year following transcatheter aortic valve replacement.

Journal Article JAMA · March 10, 2015 IMPORTANCE: Introducing new medical devices into routine practice raises concerns because patients and outcomes may differ from those in randomized trials. OBJECTIVE: To update the previous report of 30-day outcomes and present 1-year outcomes following tr ... Full text Link to item Cite

The impact of high-risk cases on hospitals' risk-adjusted coronary artery bypass grafting mortality rankings.

Journal Article Ann Thorac Surg · March 2015 BACKGROUND: Risk-adjusted mortality (RAM) models are increasingly used to evaluate hospital performance, but the validity of the RAM method has been questioned. Providers are concerned that these methods might not adequately account for the highest levels ... Full text Link to item Cite

Cost-effectiveness of revascularization strategies: the ASCERT study.

Journal Article J Am Coll Cardiol · January 6, 2015 BACKGROUND: ASCERT (American College of Cardiology Foundation and the Society of Thoracic Surgeons Collaboration on the Comparative Effectiveness of Revascularization Strategies) was a large observational study designed to compare the long-term effectivene ... Full text Link to item Cite

Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients.

Journal Article Ann Thorac Surg · January 2015 BACKGROUND: The introduction of transcatheter aortic valve replacement mandates attention to outcomes after surgical aortic valve replacement (SAVR) in low-risk, intermediate-risk, and very high-risk patients. METHODS: The study population included 141,905 ... Full text Link to item Cite

Long-Term Clinical Outcomes of Silzone Era St. Jude Medical Mechanical Heart Valves.

Journal Article J Heart Valve Dis · January 2015 BACKGROUND AND AIM OF THE STUDY: Since the voluntary recall of St. Jude Medical (SJM) Silzone impregnated heart valves, no large-scale study has examined their long-term outcomes. METHODS: Using Medicare-linked records from the Society of Thoracic Surgeons ... Link to item Cite

Empirically based tools for analyzing mortality and morbidity associated with congenital heart surgery

Chapter · January 1, 2015 Congenital heart surgery outcomes analysis requires reliable methods of estimating the risk of adverse outcomes. In the past, methods used for risk adjusted comparisons of outcomes from congenital heart surgery relied on expert opinion about perceived comp ... Full text Cite

Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery

Chapter · January 1, 2015 The analysis and reporting of patient outcomes plays a major role in congenital cardiac surgery quality improvement and accountability initiatives. Although outcomes analysis can lead to important insights, factors such as wide patient heterogeneity and sm ... Full text Cite

Epidemiology and outcomes after in-hospital cardiac arrest after pediatric cardiac surgery.

Journal Article Ann Thorac Surg · December 2014 BACKGROUND: Multicenter data regarding cardiac arrest in children undergoing heart operations are limited. We describe epidemiology and outcomes associated with postoperative cardiac arrest in a large multiinstitutional cohort. METHODS: Patients younger th ... Full text Link to item Cite

The association of transcatheter aortic valve replacement availability and hospital aortic valve replacement volume and mortality in the United States.

Journal Article Ann Thorac Surg · December 2014 BACKGROUND: Whether the introduction of transcatheter aortic valve replacement (TAVR) has affected hospitals' surgical aortic valve replacement (SAVR) and overall aortic valve replacement (AVR) case volumes and outcomes in the United States is unknown. MET ... Full text Link to item Cite

ACC/AHA/AACVPR/AAFP/ANA concepts for clinician-patient shared accountability in performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.

Journal Article J Am Coll Cardiol · November 18, 2014 Developed in collaboration with the National Committee for Quality Assurance, the American Society of Health-System Pharmacists, and the American Medical Association–Physician Consortium for Performance Improvement Endorsed by the American Society of Healt ... Full text Link to item Cite

The importance of patient-specific preoperative factors: an analysis of the society of thoracic surgeons congenital heart surgery database.

Journal Article Ann Thorac Surg · November 2014 BACKGROUND: The most common forms of risk adjustment for pediatric and congenital heart surgery used today are based mainly on the estimated risk of mortality of the primary procedure of the operation. The goals of this analysis were to assess the associat ... Full text Link to item Cite

Practice patterns and clinical outcomes after hybrid coronary revascularization in the United States: an analysis from the society of thoracic surgeons adult cardiac database.

Journal Article Circulation · September 9, 2014 BACKGROUND: Hybrid coronary revascularization (HCR) involves a combination of surgical and percutaneous techniques, which in selected patients may present an alternative to conventional coronary artery bypass grafting (CABG). METHODS AND RESULTS: Patients ... Full text Link to item Cite

Surgeon and center volume influence on outcomes after arterial switch operation: analysis of the STS Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · September 2014 BACKGROUND: The relative impact of center volume and of surgeon volume on early outcomes after the arterial switch operation (ASO) is incompletely understood. METHODS: Neonates in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2005-201 ... Full text Link to item Cite

Trends in use of off-pump coronary artery bypass grafting: Results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article J Thorac Cardiovasc Surg · September 2014 OBJECTIVES: Recent national trends in off-pump versus on-pump coronary artery bypass grafting have not been reported. METHODS: We analyzed data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database regarding isolated primary coronary artery ... Full text Link to item Cite

Does mitral valve repair offer an advantage over replacement in patients undergoing aortic valve replacement?

Journal Article Ann Thorac Surg · August 2014 BACKGROUND: Concomitant aortic and mitral valve (MV) operations have more than doubled over the past decade. We utilized the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD) to evaluate outcomes for patients undergoing combined aortic val ... Full text Link to item Cite

Preoperative β-blocker use in coronary artery bypass grafting surgery: national database analysis.

Journal Article JAMA Intern Med · August 2014 IMPORTANCE: Use of preoperative β-blockers has been associated with a reduction in perioperative mortality for patients undergoing coronary artery bypass grafting (CABG) surgery in observational research studies, which led to the adoption of preoperative β ... Full text Link to item Cite

Development of a clinical registry-based 30-day readmission measure for coronary artery bypass grafting surgery.

Journal Article Circulation · July 29, 2014 BACKGROUND: Reducing readmissions is a major healthcare reform goal, and reimbursement penalties are imposed for higher-than-expected readmission rates. Most readmission risk models and performance measures are based on administrative rather than clinical ... Full text Link to item Cite

Concomitant tricuspid valve surgery during implantation of continuous-flow left ventricular assist devices: a Society of Thoracic Surgeons database analysis.

Journal Article J Heart Lung Transplant · June 2014 BACKGROUND: Performing concomitant tricuspid valve procedures (TVPs) in left ventricular assist device (LVAD) patients with significant pre-operative tricuspid regurgitation (TR) is controversial, and no studies have been large enough to definitively guide ... Full text Link to item Cite

Composite outcomes in coronary bypass surgery versus percutaneous intervention.

Journal Article Ann Thorac Surg · June 2014 BACKGROUND: Recent observational studies show that patients with multivessel coronary disease have a long-term survival advantage with coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI). Important nonfatal outcome ... Full text Link to item Cite

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

Journal Article 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 repl ... Full text Link to item Cite

Angiographic validation of the American College of Cardiology Foundation-the Society of Thoracic Surgeons Collaboration on the Comparative Effectiveness of Revascularization Strategies study.

Journal Article Circ Cardiovasc Interv · February 2014 BACKGROUND: The goal of this study was to compare angiographic interpretation of coronary arteriograms by sites in community practice versus those made by a centralized angiographic core laboratory. METHODS AND RESULTS: The study population consisted of 20 ... Full text Link to item Cite

Rethinking the ross procedure in adults.

Journal Article Ann Thorac Surg · January 2014 BACKGROUND: Although questionable durability has tempered enthusiasm for the Ross procedure in the last decade, the perioperative risks of the Ross procedure relative to conventional aortic valve replacement are not well described. The goal of this study i ... Full text Link to item Cite

Doubly-robust estimators of treatment-specific survival distributions in observational studies with stratified sampling.

Journal Article Biometrics · December 2013 Observational studies are frequently conducted to compare the effects of two treatments on survival. For such studies we must be concerned about confounding; that is, there are covariates that affect both the treatment assignment and the survival distribut ... Full text Link to item Cite

Outcomes following transcatheter aortic valve replacement in the United States.

Journal Article JAMA · November 20, 2013 IMPORTANCE: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for the treatment of severe, symptomatic aortic stenosis and inoperable status (in 2011) and high-risk but operable status (starting in 2012). A n ... Full text Link to item Cite

Isolated mitral valve surgery risk in 77,836 patients from the Society of Thoracic Surgeons database.

Journal Article Ann Thorac Surg · November 2013 BACKGROUND: Understanding the operative outcomes of mitral valve (MV) surgery across the spectrum of predicted risk of mortality (PROM) is necessary to determine the best use of novel percutaneous approaches. METHODS: The Society of Thoracic Surgeons Adult ... Full text Link to item Cite

Current outcomes for tricuspid valve infective endocarditis surgery in North America.

Journal Article Ann Thorac Surg · October 2013 BACKGROUND: Tricuspid valve (TV) infective endocarditis (IE) accounts for 15% of IE cases and usually is treated medically. Surgical intervention is rare, and understanding of treatment options is based on small series of patients. The purpose of this stud ... Full text Link to item Cite

Associations between valve repair and reduced operative mortality in 21,056 mitral/tricuspid double valve procedures.

Journal Article Eur J Cardiothorac Surg · September 2013 OBJECTIVES: Repair of either the mitral (M) or tricuspid (T) valve in single valve surgery is associated with reduced operative mortality. It is unclear, however, how valve repair influences mortality in combined MT procedures. This topic was evaluated in ... Full text Link to item Cite

Variation in ventilation time after coronary artery bypass grafting: an analysis from the society of thoracic surgeons adult cardiac surgery database.

Journal Article Ann Thorac Surg · September 2013 BACKGROUND: Short postoperative ventilation times are accepted as a marker of quality. This analysis assesses center level variation in postoperative ventilation time in a subset of patients undergoing isolated coronary artery bypass grafting (CABG). METHO ... Full text Link to item Cite

Issues in quality measurement: target population, risk adjustment, and ratings.

Journal Article Ann Thorac Surg · August 2013 This review investigates three fundamental issues in health care performance measurement: selection of a homogeneous target population, risk adjustment, and assignment of quality rating categories. Many but not all organizations involved in quality measure ... Full text Link to item Cite

Variation in warfarin thromboprophylaxis after mitral valve repair: does equipoise exist and is a randomized trial warranted?

Journal Article Ann Thorac Surg · June 2013 BACKGROUND: There are limited data available to inform decision making regarding warfarin thromboprophylaxis early after mitral valve repair. METHODS: We studied 13,082 patients from The Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD ... Full text Link to item Cite

Outcomes of off-pump versus on-pump coronary artery bypass grafting: Impact of preoperative risk.

Journal Article J Thorac Cardiovasc Surg · May 2013 BACKGROUND: It is unknown whether purported benefits of off-pump coronary artery bypass grafting are patient-specific within the Society of Thoracic Surgeons National Cardiac Database or dependent on center volume or operating surgeon. METHODS: The Society ... Full text Link to item Cite

Long-term safety and effectiveness of mechanical versus biologic aortic valve prostheses in older patients: results from the Society of Thoracic Surgeons Adult Cardiac Surgery National Database.

Journal Article Circulation · April 23, 2013 BACKGROUND: There is a paucity of long-term data comparing biological versus mechanical aortic valve prostheses in older individuals. METHODS AND RESULTS: We performed follow-up of patients aged 65 to 80 years undergoing aortic valve replacement with a bio ... Full text Link to item Cite

An empirically based tool for analyzing morbidity associated with operations for congenital heart disease.

Journal Article J Thorac Cardiovasc Surg · April 2013 OBJECTIVE: Congenital heart surgery outcomes analysis requires reliable methods of estimating the risk of adverse outcomes. Contemporary methods focus primarily on mortality or rely on expert opinion to estimate morbidity associated with different procedur ... Full text Link to item Cite

Successful linking of the Society of Thoracic Surgeons Database to Social Security data to examine the accuracy of Society of Thoracic Surgeons mortality data.

Journal Article J Thorac Cardiovasc Surg · April 2013 OBJECTIVES: The Society of Thoracic Surgeons Adult Cardiac Surgery Database has been linked to the Social Security Death Master File to verify "life status" and evaluate long-term surgical outcomes. The objective of this study is explore practical applicat ... Full text Link to item Cite

The Society of Thoracic Surgeons risk model for operative mortality after multiple valve surgery.

Journal Article Ann Thorac Surg · April 2013 BACKGROUND: This study was undertaken to develop The Society of Thoracic Surgeons (STS) mortality risk models for multiple valve procedures, which comprise 12% of total valve operations. METHODS: Data were obtained from the STS Adult Cardiac Surgery Databa ... Full text Link to item Cite

Exercises and solutions in statistical theory

Book · January 1, 2013 Exercises and Solutions in Statistical Theory helps students and scientists obtain an in-depth understanding of statistical theory by working on and reviewing solutions to interesting and challenging exercises of practical importance. Unlike similar books, ... Full text Cite

Effects of institutional volumes on operative outcomes for aortic root replacement in North America.

Journal Article J Thorac Cardiovasc Surg · January 2013 OBJECTIVES: Hospital procedure volume has been strongly associated with postoperative mortality for a number of complex cardiovascular procedures. Although not yet described, a similar relationship might be expected for surgical procedures involving the ao ... Full text Link to item Cite

Report from the Society of Thoracic Surgeons National Database Workforce: clarifying the definition of operative mortality.

Journal Article World J Pediatr Congenit Heart Surg · January 2013 Several distinct definitions of postoperative death have been used in various quality reporting programs. Some have defined postoperative mortality as the occurrence of death after a surgical procedure when the patient dies while still in the hospital, whi ... Full text Link to item Cite

Longitudinal outcome of isolated mitral repair in older patients: results from 14,604 procedures performed from 1991 to 2007.

Journal Article Ann Thorac Surg · December 2012 BACKGROUND: Mitral valve (MV) repair is performed with less frequency than MV replacement in older persons, with referral often delayed until symptoms are severe. Surgical practice in this population remains inconsistent in the absence of national MV repai ... Full text Link to item Cite

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

Journal Article 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 b ... Full text Link to item Cite

Long-term outcomes after transmyocardial revascularization.

Journal Article Ann Thorac Surg · November 2012 BACKGROUND: Two independent reports documented substantially higher operative mortality associated with transmyocardial revascularization (TMR) when used in isolation than that reported in the premarket clinical trials. To clarify the state of the art, thi ... Full text Link to item Cite

Surgical ablation of atrial fibrillation trends and outcomes in North America.

Journal Article J Thorac Cardiovasc Surg · November 2012 OBJECTIVE: Despite growing awareness of the clinical significance of atrial fibrillation (AF) and observational data demonstrating the safety and efficacy of surgical therapy, AF ablation is variably performed among patients with AF undergoing cardiac surg ... Full text Link to item Cite

Mentored simulation training improves procedural skills in cardiac catheterization: a randomized, controlled pilot study.

Journal Article Circ Cardiovasc Interv · October 2012 BACKGROUND: Despite valuable supplemental training resources for surgical skill acquisition, utility of virtual reality simulators to improve skills relevant to performing cardiac catheterization has not been evaluated. METHODS AND RESULTS: Post baseline c ... Full text Link to item Cite

Long-term survival after aortic valve replacement among high-risk elderly patients in the United States: insights from the Society of Thoracic Surgeons Adult Cardiac Surgery Database, 1991 to 2007.

Journal Article Circulation · September 25, 2012 BACKGROUND: Surgical aortic valve replacement (AVR) remains the standard of care for the treatment of operable, symptomatic aortic valve disease; however, to date, there are limited national data on the contemporary long-term outcomes after AVR in older in ... Full text Link to item Cite

Contemporary results for proximal aortic replacement in North America.

Journal Article J Am Coll Cardiol · September 25, 2012 OBJECTIVES: The purpose of this study was to characterize operative outcomes for ascending aorta and arch replacement on a national scale and to develop risk models for mortality and major morbidity. BACKGROUND: Contemporary outcomes for ascending aorta an ... Full text Link to item Cite

Early anticoagulation of bioprosthetic aortic valves in older patients: results from the Society of Thoracic Surgeons Adult Cardiac Surgery National Database.

Journal Article J Am Coll Cardiol · September 11, 2012 OBJECTIVES: The aim of this study was to evaluate the risks and benefits of short-term anticoagulation in patients receiving aortic valve bioprostheses. BACKGROUND: Patients receiving aortic valve bioprostheses have an elevated early risk of thromboembolic ... Full text Link to item Cite

Association between endoscopic vs open vein-graft harvesting and mortality, wound complications, and cardiovascular events in patients undergoing CABG surgery.

Journal Article JAMA · August 1, 2012 CONTEXT: The safety and durability of endoscopic vein graft harvest in coronary artery bypass graft (CABG) surgery has recently been called into question. OBJECTIVE: To compare the long-term outcomes of endoscopic vs open vein-graft harvesting for Medicare ... Full text Link to item Cite

Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the STS Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · August 2012 BACKGROUND: We evaluated outcomes for groups of risk-stratified operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database to provide contemporary benchmarks and examine variation between centers. METHODS: Patients undergoing surgery ... Full text Link to item Cite

Evaluation of failure to rescue as a quality metric in pediatric heart surgery: an analysis of the STS Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · August 2012 BACKGROUND: Failure to rescue (FTR; the probability of death after a complication) has been adopted as a quality metric in adult cardiac surgery, in which it has been shown that high-performing centers with low mortality rates do not have fewer complicatio ... Full text Link to item Cite

Relative impact of surgeon and center volume on early mortality after the Norwood operation.

Journal Article Ann Thorac Surg · June 2012 BACKGROUND: Previous studies suggest center volume is associated with outcome after the Norwood operation; however, the impact of surgeon volume is less clear. We evaluated the relative impact of surgeon and center volume on mortality in a large Norwood co ... Full text Link to item Cite

The complex relationship between center volume and outcome in patients undergoing the Norwood operation.

Journal Article Ann Thorac Surg · May 2012 BACKGROUND: Norwood outcomes vary across centers, and a relationship between center volume and outcome has been previously described. It is unclear whether this volume-outcome relationship exists across all levels of patient risk or holds true for all cent ... Full text Link to item Cite

Comparative effectiveness of revascularization strategies.

Journal Article N Engl J Med · April 19, 2012 BACKGROUND: Questions persist concerning the comparative effectiveness of percutaneous coronary intervention (PCI) and coronary-artery bypass grafting (CABG). The American College of Cardiology Foundation (ACCF) and the Society of Thoracic Surgeons (STS) c ... Full text Link to item Cite

Predictors of long-term survival after coronary artery bypass grafting surgery: results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (the ASCERT study).

Journal Article Circulation · March 27, 2012 BACKGROUND: Most survival prediction models for coronary artery bypass grafting surgery are limited to in-hospital or 30-day end points. We estimate a long-term survival model using data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database ... Full text Link to item Cite

Prediction of long-term mortality after percutaneous coronary intervention in older adults: results from the National Cardiovascular Data Registry.

Journal Article Circulation · March 27, 2012 BACKGROUND: The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infarction and those with more stable coronary disease. METHODS AND R ... Full text Link to item Cite

Comparative analysis of antifibrinolytic medications in pediatric heart surgery.

Journal Article J Thorac Cardiovasc Surg · March 2012 OBJECTIVES: Recent studies suggest adverse events associated with aprotinin in adults may not occur in children, and there is interest in further pediatric study of aprotinin. However, there are limited contemporary data comparing aprotinin with other avai ... Full text Link to item Cite

Perioperative methylprednisolone and outcome in neonates undergoing heart surgery.

Journal Article Pediatrics · February 2012 BACKGROUND: Recent studies have called into question the benefit of perioperative corticosteroids in children undergoing heart surgery, but have been limited by the lack of placebo control, limited power, and grouping of various steroid regimens together i ... Full text Link to item Cite

Association of center volume with mortality and complications in pediatric heart surgery.

Journal Article Pediatrics · February 2012 OBJECTIVE: Previous analyses have suggested center volume is associated with outcome in children undergoing heart surgery. However, data are limited regarding potential mediating factors, including the relationship of center volume with postoperative compl ... Full text Link to item Cite

Trends in isolated coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons adult cardiac surgery database.

Journal Article J Thorac Cardiovasc Surg · February 2012 OBJECTIVE: Coronary artery bypass grafting (CABG) is the operation most commonly performed by cardiac surgeons. There are few contemporary data examining evolving patient characteristics and surgical outcomes of isolated CABG. We used the Society of Thorac ... Full text Link to item Cite

Patterns of anticoagulation following bioprosthetic valve implantation: observations from ANSWER.

Journal Article J Heart Valve Dis · January 2012 BACKGROUND AND AIM OF THE STUDY: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend a three-month administration of warfarin following bioprosthetic valve replacement (BVR). However, strong evidence supporting this ... Link to item Cite

Reply

Journal Article Annals of Thoracic Surgery · January 1, 2012 Full text Cite

Outcomes of repair of common arterial trunk with truncal valve surgery: a review of the society of thoracic surgeons congenital heart surgery database.

Journal Article Ann Thorac Surg · January 2012 BACKGROUND: Previous studies have suggested truncal valve insufficiency may adversely affect outcome after common arterial trunk (CAT) repair. It is unknown if truncal insufficiency requiring truncal valve surgery (TVS) at the time of primary CAT repair im ... Full text Link to item Cite

Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · December 2011 BACKGROUND: We evaluated outcomes for common operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSDB) to provide contemporary benchmarks and examine variation between centers. METHODS: Patients undergoing surgery from 20 ... Full text Link to item Cite

Association between physician billing and cardiac stress testing patterns following coronary revascularization.

Journal Article JAMA · November 9, 2011 CONTEXT: The degree to which financial factors may influence use of cardiac stress imaging procedures is unknown. OBJECTIVE: To examine the association of physician billing and nuclear stress and stress echocardiography testing following coronary revascula ... Full text Link to item Cite

Postoperative inotrope and vasopressor use following CABG: outcome data from the CAPS-care study.

Journal Article J Card Surg · November 2011 BACKGROUND/AIM: Limited clinical data exist to guide practice patterns and evidence-based use of inotropes and vasopressors following coronary artery bypass grafting (CABG). METHODS: Contemporary Analysis of Perioperative Cardiovascular Surgical Care (CAPS ... Full text Link to item Cite

Comparison of composite measure methodologies for rewarding quality of care: an analysis from the American Heart Association's Get With The Guidelines program.

Journal Article Circ Cardiovasc Qual Outcomes · November 1, 2011 BACKGROUND: Composite indices of health care performance are an aggregation of underlying individual performance measures and are increasingly being used to rank hospitals. We sought to conduct an observational analysis to determine the influence of the op ... Full text Link to item Cite

Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

Journal Article Ann Thorac Surg · November 2011 BACKGROUND: Limited multicenter data exist regarding the prevalence of postoperative complications after the Norwood operation and their associated mortality risk. METHODS: We evaluated infants in The Society of Thoracic Surgeons Congenital Heart Surgery D ... Full text Link to item Cite

Regional variation in patient risk factors and mortality after coronary artery bypass grafting.

Journal Article Ann Thorac Surg · October 2011 BACKGROUND: Geographic variations in patient risk factors and operative mortality after coronary artery bypass graft surgery have not been well studied. METHODS: Using The Society of Thoracic Surgeons National Cardiac Database, a retrospective cohort study ... Full text Link to item Cite

Relationship of the time interval between cardiac catheterization and elective coronary artery bypass surgery with postprocedural acute kidney injury.

Journal Article Circulation · September 13, 2011 BACKGROUND: Some prior studies have suggested that the time to cardiac surgery after cardiac catheterization is inversely related to postoperative acute kidney injury (AKI). However, these studies, because of the small number of patients, were unable to ad ... Full text Link to item Cite

Public reporting of cardiac surgery performance: Part 2--implementation.

Journal Article Ann Thorac Surg · September 2011 Appropriate implementation is essential to create a credible public reporting system. Ideally, data should be obtained from an audited clinical data registry, and structure, process, or outcomes metrics may be reported. Composite measures are increasingly ... Full text Link to item Cite

Public reporting of cardiac surgery performance: Part 1--history, rationale, consequences.

Journal Article Ann Thorac Surg · September 2011 Cardiac surgical report cards have historically been mandatory. This paradigm changed when The Society of Thoracic Surgeons recently implemented a voluntary public reporting program based on benchmark analyses from its National Cardiac Database. The primar ... Full text Link to item Cite

Nonparametric Bayes Stochastically Ordered Latent Class Models.

Journal Article J Am Stat Assoc · September 1, 2011 Latent class models (LCMs) are used increasingly for addressing a broad variety of problems, including sparse modeling of multivariate and longitudinal data, model-based clustering, and flexible inferences on predictor effects. Typical frequentist LCMs req ... Full text Link to item Cite

Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure.

Journal Article Ann Thorac Surg · August 2011 BACKGROUND: Perioperative advances have led to significant improvements in outcomes after many complex neonatal open heart procedures. Whether similar improvements have been realized for the modified Blalock-Taussig shunt, the most common palliative neonat ... Full text Link to item Cite

Care processes associated with quicker door-in-door-out times for patients with ST-elevation-myocardial infarction requiring transfer: results from a statewide regionalization program.

Journal Article Circ Cardiovasc Qual Outcomes · July 2011 BACKGROUND: The ability to rapidly identify patients with ST-segment elevation-myocardial infarction (STEMI) at hospitals without percutaneous coronary intervention (PCI) and transfer them to hospitals with PCI capability is critical to STEMI regionalizati ... Full text Link to item Cite

Successful linking of the Society of Thoracic Surgeons database to social security data to examine survival after cardiac operations.

Journal Article Ann Thorac Surg · July 2011 BACKGROUND: Long-term evaluation of cardiothoracic surgical outcomes is a major goal of The Society of Thoracic Surgeons (STS). Linking the STS Database to the Social Security Death Master File (SSDMF) allows for the verification of "life status." This stu ... Full text Link to item Cite

Care models and associated outcomes in congenital heart surgery.

Journal Article Pediatrics · June 2011 OBJECTIVE: Recently, there has been a shift toward care of children undergoing heart surgery in dedicated pediatric cardiac intensive care units (CICU). The impact of this trend on patient outcomes is unclear. We evaluated postoperative outcomes associated ... Full text Link to item Cite

Center variation in patient age and weight at Fontan operation and impact on postoperative outcomes.

Journal Article Ann Thorac Surg · May 2011 BACKGROUND: The impact of age and weight on outcomes after the Fontan operation is unclear. Previous analyses have suggested that lower weight-for-age z-score is an important predictor of poor outcome in patients undergoing bidirectional Glenn. We evaluate ... Full text Link to item Cite

Lessons learned from 119 consecutive cardiac transplants for pediatric and congenital heart disease.

Journal Article Ann Thorac Surg · April 2011 BACKGROUND: This manuscript reviews all patients who underwent orthotopic heart transplantations (OHT) at our program (116 patients underwent 119 OHT) to describe their diagnostic characteristics and to assess risk factors for mortality. METHODS: Median ag ... Full text Link to item Cite

PATIENT RISK STATUS, CENTER VOLUME AND OUTCOME FOLLOWING THE NORWOOD OPERATION

Conference Journal of the American College of Cardiology · April 2011 Full text Cite

Fifteen-year outcome trends for valve surgery in North America.

Journal Article Ann Thorac Surg · March 2011 BACKGROUND: Although results in valvular heart surgery may be improving, too few cases are available in most centers to quantify changes, especially for uncommon procedural categories. This study examined comprehensively national trends in valve surgery ou ... Full text Link to item Cite

Do physicians' attitudes toward implantable cardioverter defibrillator therapy vary by patient age, gender, or race?

Journal Article Ann Noninvasive Electrocardiol · January 2011 BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy improves survival of patients with systolic heart failure. We assessed whether physicians' recommendation for ICD therapy varies as a function of patient age, gender, race, and physician's sp ... Full text Link to item Cite

Outcomes for endocarditis surgery in North America: a simplified risk scoring system.

Journal Article J Thorac Cardiovasc Surg · January 2011 OBJECTIVE: Operation for infective endocarditis is associated with the highest mortality of any valve disease, with overall rates of in-hospital mortality exceeding 20%. The Society of Thoracic Surgeons Adult Cardiac Surgery Database was examined to develo ... Full text Link to item Cite

Public reporting of cardiac surgery performance: Part 1 - History, rationale, consequences

Journal Article Annals of Thoracic Surgery · January 1, 2011 Cardiac surgical report cards have historically been mandatory. This paradigm changed when The Society of Thoracic Surgeons recently implemented a voluntary public reporting program based on benchmark analyses from its National Cardiac Database. The primar ... Full text Cite

Linking clinical registry data with administrative data using indirect identifiers: implementation and validation in the congenital heart surgery population.

Journal Article Am Heart J · December 2010 BACKGROUND: The use of clinical registries and administrative data sets in pediatric cardiovascular research has become increasingly common. However, this approach is limited by relatively few existing datasets, each of which contain limited data, and do n ... Full text Link to item Cite

Predictors of mitral valve repair: clinical and surgeon factors.

Journal Article Ann Thorac Surg · December 2010 BACKGROUND: Mitral valve repair is acknowledged as desirable and superior to replacement for virtually all mitral pathology. Utilizing The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD), a multivariable model was created that incl ... Full text Link to item Cite

J. Maxwell Chamberlain Memorial Paper for adult cardiac surgery. Less-invasive mitral valve operations: trends and outcomes from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article Ann Thorac Surg · November 2010 BACKGROUND: The purpose of this study was to examine utilization and outcomes of less-invasive mitral valve (LIMV) operations in North America. METHODS: Between 2004 and 2008, 28,143 patients undergoing isolated mitral valve (MV) operations were identified ... Full text Link to item Cite

Variation in use of blood transfusion in coronary artery bypass graft surgery.

Journal Article JAMA · October 13, 2010 CONTEXT: Perioperative blood transfusions are costly and have safety concerns. As a result, there have been multiple initiatives to reduce transfusion use. However, the degree to which perioperative transfusion rates vary among hospitals is unknown. OBJECT ... Full text Link to item Cite

Patterns of cardiac stress testing after revascularization in community practice.

Journal Article J Am Coll Cardiol · October 12, 2010 OBJECTIVES: The purpose of this study was to determine the pattern of cardiac stress testing after coronary revascularization in community practice. BACKGROUND: The American College of Cardiology Foundation appropriate use criteria provide guidance for the ... Full text Link to item Cite

Successful linking of the Society of Thoracic Surgeons adult cardiac surgery database to Centers for Medicare and Medicaid Services Medicare data.

Journal Article Ann Thorac Surg · October 2010 BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) Medicare database complements The Society of Thoracic Surgeons (STS) database by providing information about long-term outcomes and cost. This study demonstrates the feasibility of linking ST ... Full text Link to item Cite

Current outcomes of simultaneous carotid endarterectomy and coronary artery bypass graft surgery in North America.

Journal Article World J Surg · October 2010 OBJECTIVE: Management of patients with concomitant carotid and coronary artery disease has been controversial. Divergent strategies have been employed, including simultaneous carotid endarterectomy and coronary bypass (SCC) versus various staged procedures ... Full text Link to item Cite

Rapid molecular detection of tuberculosis and rifampin resistance.

Journal Article N Engl J Med · September 9, 2010 BACKGROUND: Global control of tuberculosis is hampered by slow, insensitive diagnostic methods, particularly for the detection of drug-resistant forms and in patients with human immunodeficiency virus infection. Early detection is essential to reduce the d ... Full text Link to item Cite

Impact of a statewide ST-segment-elevation myocardial infarction regionalization program on treatment times for women, minorities, and the elderly.

Journal Article Circ Cardiovasc Qual Outcomes · September 2010 BACKGROUND: Prior studies have demonstrated differences in time to reperfusion for ST-segment-elevation myocardial infarction (STEMI) in women, minorities, and the elderly, relative to their counterparts. Regionalization has been shown to improve overall S ... Full text Link to item Cite

STS database risk models: predictors of mortality and major morbidity for lung cancer resection.

Journal Article Ann Thorac Surg · September 2010 BACKGROUND: The aim of this study is to create models for perioperative risk of lung cancer resection using the STS GTDB (Society of Thoracic Surgeons General Thoracic Database). METHODS: The STS GTDB was queried for all patients treated with resection for ... Full text Link to item Cite

Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons Database.

Journal Article Ann Thorac Surg · September 2010 BACKGROUND: The Society of Thoracic Surgeons Database was queried to ascertain current trends in management of tetralogy of Fallot (TOF) and to determine the prevalence of various surgical techniques. METHODS: The study population (n = 3059 operations) was ... Full text Link to item Cite

Risk factors for atrial fibrillation after lung cancer surgery: analysis of the Society of Thoracic Surgeons general thoracic surgery database.

Journal Article Ann Thorac Surg · August 2010 BACKGROUND: Atrial fibrillation is responsible for significant morbidity after lung cancer surgery, and preoperative and perioperative risk factors are not well described. METHODS: The Society of Thoracic Surgeons (STS) database was queried for all lobecto ... Full text Link to item Cite

Congenital heart surgery outcomes in Down syndrome: analysis of a national clinical database.

Journal Article Pediatrics · August 2010 OBJECTIVE: We describe patient characteristics and postoperative morbidity and mortality rates for patients with Down syndrome undergoing congenital heart disease surgery. METHODS: This retrospective cohort study used the Society of Thoracic Surgeons Conge ... Full text Link to item Cite

Center variation and outcomes associated with delayed sternal closure after stage 1 palliation for hypoplastic left heart syndrome.

Journal Article J Thorac Cardiovasc Surg · May 2010 OBJECTIVE: There is debate whether primary or delayed sternal closure is the best strategy after stage 1 palliation for hypoplastic left heart syndrome. We describe center variation in delayed sternal closure after stage 1 palliation and associated outcome ... Full text Link to item Cite

Major infection after pediatric cardiac surgery: a risk estimation model.

Journal Article Ann Thorac Surg · March 2010 BACKGROUND: In pediatric cardiac surgery, infection is a leading cause of morbidity and mortality. We created a model to predict risk of major infection in this population. METHODS: Using the Society of Thoracic Surgeons Congenital Heart Surgery Database, ... Full text Link to item Cite

Association of hospital coronary artery bypass volume with processes of care, mortality, morbidity, and the Society of Thoracic Surgeons composite quality score.

Journal Article J Thorac Cardiovasc Surg · February 2010 OBJECTIVE: This study examines the association of hospital coronary artery bypass procedural volume with mortality, morbidity, evidence-based care processes, and Society of Thoracic Surgeons composite score. METHODS: The study population consisted of 144,5 ... Full text Link to item Cite

An empirically based tool for analyzing mortality associated with congenital heart surgery.

Journal Article J Thorac Cardiovasc Surg · November 2009 OBJECTIVE: Analysis of congenital heart surgery results requires a reliable method of estimating the risk of adverse outcomes. Two major systems in current use are based on projections of risk or complexity that were predominantly subjectively derived. Our ... Full text Link to item Cite

Reoperation for bleeding in patients undergoing coronary artery bypass surgery: incidence, risk factors, time trends, and outcomes.

Journal Article Circ Cardiovasc Qual Outcomes · November 2009 BACKGROUND: Reoperation for bleeding represents an important complication in patients undergoing coronary artery bypass surgery (CABG). Yet, few studies have characterized risk factors and patient outcomes of this event. METHODS AND RESULTS: We evaluated 5 ... Full text Link to item Cite

Stratification of complexity improves the utility and accuracy of outcomes analysis in a Multi-Institutional Congenital Heart Surgery Database: Application of the Risk Adjustment in Congenital Heart Surgery (RACHS-1) and Aristotle Systems in the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database.

Journal Article Pediatr Cardiol · November 2009 Quality-of-care evaluation must take into account variations in "ase mix."This study reviewed the application of two case-mix complexity-adjustment tools in the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database: the Aristotle Basic Compl ... Full text Link to item Cite

Prevalence and variability of internal mammary artery graft use in contemporary multivessel coronary artery bypass graft surgery: analysis of the Society of Thoracic Surgeons National Cardiac Database.

Journal Article Circulation · September 15, 2009 BACKGROUND: Use of an internal mammary artery (IMA) is a well-recognized, nationally endorsed quality indicator for evaluating the process of operative care for coronary artery bypass graft surgery. An objective assessment of the current status of IMA use ... Full text Link to item Cite

Variation in perioperative vasoactive therapy in cardiovascular surgical care: data from the Society of Thoracic Surgeons.

Journal Article Am Heart J · July 2009 BACKGROUND: The appropriate use of vasoactive cardiovascular drugs in high-risk coronary artery bypass grafting (CABG) patients has not been well characterized. METHODS: We performed a detailed chart analysis on 2,390 randomly selected patients undergoing ... Full text Link to item Cite

The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1--coronary artery bypass grafting surgery.

Journal Article Ann Thorac Surg · July 2009 BACKGROUND: The first version of The Society of Thoracic Surgeons National Adult Cardiac Surgery Database (STS NCD) was developed nearly 2 decades ago. Since its inception, the number of participants has grown dramatically, patient acuity has increased, an ... Full text Link to item Cite

The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 2--isolated valve surgery.

Journal Article Ann Thorac Surg · July 2009 BACKGROUND: Adjustment for case-mix is essential when using observational data to compare surgical techniques or providers. That is most often accomplished through the use of risk models that account for preoperative patient factors that may impact outcome ... Full text Link to item Cite

The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 3--valve plus coronary artery bypass grafting surgery.

Journal Article Ann Thorac Surg · July 2009 BACKGROUND: Since 1999, The Society of Thoracic Surgeons (STS) has published two risk models that can be used to adjust the results of valve surgery combined with coronary artery bypass graft surgery (CABG). The most recent was developed from data for pati ... Full text Link to item Cite

The complex relationship between pediatric cardiac surgical case volumes and mortality rates in a national clinical database.

Journal Article J Thorac Cardiovasc Surg · May 2009 OBJECTIVE: We sought to determine the association between pediatric cardiac surgical volume and mortality using sophisticated case-mix adjustment and a national clinical database. METHODS: Patients 18 years of age or less who had a cardiac operation betwee ... Full text Link to item Cite

Trends in mitral valve surgery in the United States: results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Journal Article Ann Thorac Surg · May 2009 BACKGROUND: The purpose of this study is to examine trends in mitral valve (MV) repair and replacement surgery using The Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD). METHODS: The study population included isolated mitral valve op ... Full text Link to item Cite

Does preoperative atrial fibrillation increase the risk for mortality and morbidity after coronary artery bypass grafting?

Journal Article J Thorac Cardiovasc Surg · April 2009 OBJECTIVES: Preoperative atrial fibrillation has been associated with less favorable outcomes in patients undergoing coronary artery bypass grafting. However, it was never investigated in a large cohort of patients using a national database. This study aim ... Full text Link to item Cite

The Importance of Clinical Predictors of 30-Day Mortality Among Medicare Beneficiaries

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY · March 10, 2009 Link to item Cite

Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk adjustment model.

Journal Article J Thorac Cardiovasc Surg · March 2009 OBJECTIVE: To create a model for perioperative risk of esophagectomy for cancer using the Society of Thoracic Surgeons General Thoracic Database. METHODS: The Society of Thoracic Surgeons General Thoracic Database was queried for all patients treated with ... Full text Link to item Cite

Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database.

Journal Article J Thorac Cardiovasc Surg · January 2009 OBJECTIVE: More than 200,000 aortic valve replacements are performed annually worldwide. We describe changes in the aortic valve replacement population during 10 years in a large registry and analyze outcomes. METHODS: The Society of Thoracic Surgeons Nati ... Full text Link to item Cite

Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery.

Journal Article Cardiol Young · December 2008 It is universally agreed that efforts to improve quality benefit from the analysis of outcomes. Yet, it is challenging to compare results across institutions because factors other than performance also impact outcomes. Two factors that complicate the analy ... Full text Link to item Cite

Impact of case volume on hospital performance assessment.

Journal Article Arch Intern Med · June 23, 2008 BACKGROUND: Process performance measures are increasingly used to assess and reward hospital quality. The impact of small hospital case volumes on such measures is not clear. METHODS: Using data from the Hospital Quality Alliance, we examined hospital perf ... Full text Link to item Cite

Predictors of prolonged length of stay after lobectomy for lung cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk-adjustment model.

Journal Article Ann Thorac Surg · June 2008 BACKGROUND: Few reliable estimations of operative risk exist for lung cancer patients undergoing lobectomy. This study identified risk factors associated with prolonged length of hospital stay (PLOS) after lobectomy for lung cancer as a surrogate for perio ... Full text Link to item Cite

Gender differences in mortality after mitral valve operation: evidence for higher mortality in perimenopausal women.

Journal Article Ann Thorac Surg · June 2008 BACKGROUND: Hormonal status is a potentially important cause for gender differences in outcomes after cardiovascular operations. Estrogen withdrawal states may potentiate ischemia-reperfusion injury by impairing endothelial cell function and increasing inf ... Full text Link to item Cite

Management of 239 patients with hypoplastic left heart syndrome and related malformations from 1993 to 2007.

Journal Article Ann Thorac Surg · May 2008 BACKGROUND: We reviewed our entire programmatic operative experience with children with hypoplastic left heart syndrome (HLHS) and related malformations. METHODS: As of October 1, 2007, 239 patients with HLHS and related malformations underwent surgical tr ... Full text Link to item Cite

Cardiac surgery in infants with low birth weight is associated with increased mortality: analysis of the Society of Thoracic Surgeons Congenital Heart Database.

Journal Article J Thorac Cardiovasc Surg · March 2008 OBJECTIVE: The evaluation of operative mortality risk for cardiac surgery in infants with low weight is limited. To determine whether low weight is a risk factor for increased mortality, we reviewed the experience within the Society of Thoracic Surgeons Co ... Full text Link to item Cite

Atrial fibrillation correction surgery: lessons from the Society of Thoracic Surgeons National Cardiac Database.

Journal Article Ann Thorac Surg · March 2008 BACKGROUND: We used The Society of Thoracic Surgeons National Cardiac Database to document the utilization of surgical atrial fibrillation (AF) correction procedures in North America. We also examined the subset of patients having mitral valve surgery to d ... Full text Link to item Cite

Clinical characteristics and in-hospital outcomes of patients with cardiogenic shock undergoing coronary artery bypass surgery: insights from the Society of Thoracic Surgeons National Cardiac Database.

Journal Article Circulation · February 19, 2008 BACKGROUND: There exist few studies that characterize contemporary clinical features and outcomes or risk factors for operative mortality in cardiogenic shock (CS) patients undergoing coronary artery bypass grafting (CABG). METHODS AND RESULTS: We evaluate ... Full text Link to item Cite

Mayo Clinic Risk Score for percutaneous coronary intervention predicts in-hospital mortality in patients undergoing coronary artery bypass graft surgery.

Journal Article Circulation · January 22, 2008 BACKGROUND: Current risk models predict in-hospital mortality after either coronary artery bypass graft surgery or percutaneous coronary interventions separately, yet the overlap suggests that the same variables can define the risks of alternative coronary ... Full text Link to item Cite

Exploring the behavior of hospital composite performance measures: an example from coronary artery bypass surgery.

Journal Article Circulation · December 18, 2007 Featured Publication BACKGROUND: Composite scores that combine several performance measures into a single ranking are becoming the accepted metric for assessing hospital performance. In particular, the Centers for Medicare & Medicaid Services Hospital Quality Incentive Demonst ... Full text Link to item Cite

Trends in tuberculosis/human immunodeficiency virus comorbidity, United States, 1993-2004.

Journal Article Arch Intern Med · December 10, 2007 Featured Publication BACKGROUND: To our knowledge, this is the first assessment of trends in tuberculosis (TB)/human immunodeficiency virus (HIV) comorbidity in the United States based on national TB surveillance data. METHODS: We analyzed all incident TB cases reported to the ... Full text Link to item Cite

Accuracy of the aristotle basic complexity score for classifying the mortality and morbidity potential of congenital heart surgery operations.

Journal Article Ann Thorac Surg · December 2007 Featured Publication BACKGROUND: The Aristotle Basic Complexity Score (ABC score) was derived by consensus of an international surgeon panel to facilitate assessment of surgical performance for quality improvement in congenital heart surgery. The utility of the ABC score depen ... Full text Link to item Cite

Comparison of cardiac surgery volumes and mortality rates between the Society of Thoracic Surgeons and Medicare databases from 1993 through 2001.

Journal Article Ann Thorac Surg · November 2007 BACKGROUND: This study compares surgical volumes and mortality rates in the Society of Thoracic Surgeons voluntary clinical National Cardiac Database (NCD) with those from an administrative claims database (Medicare Provider Analysis and Review [MedPAR]) t ... Full text Link to item Cite

Off-pump techniques benefit men and women and narrow the disparity in mortality after coronary bypass grafting.

Journal Article Ann Thorac Surg · November 2007 BACKGROUND: Women have historically had greater morbidity and mortality than men after conventional coronary artery bypass grafting (CABG) on cardiopulmonary bypass (ONCAB). It is controversial whether off-pump CABG (OPCAB) alters this gender-based dispari ... Full text Link to item Cite

The risk of valve surgery for endocarditis in patients with dialysis-dependent renal failure.

Journal Article J Heart Valve Dis · November 2007 BACKGROUND AND AIM OF THE STUDY: Valvular endocarditis occurring in patients with dialysis-dependent renal failure increases the risk of mortality following valve surgery, but few specific data are available to guide surgical selection. The study aim was t ... Link to item Cite

A decade of short-term outcomes in post cardiac surgery ventricular assist device implantation: data from the Society of Thoracic Surgeons' National Cardiac Database.

Journal Article Circulation · August 7, 2007 BACKGROUND: Previous studies showed 75% mortality before hospital discharge in patients with a ventricular assist device (VAD) placed for post-cardiac surgery shock. We examined a large national clinical database to assess trends in the incidence of post-c ... Full text Link to item Cite

Identifying high-quality hospitals: consult the ratings or flip a coin?

Journal Article Arch Intern Med · July 9, 2007 Featured Publication Full text Link to item Cite

Impact of residency status on perfusion times and outcomes for coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2007 BACKGROUND: A price of training residents in cardiothoracic surgery is often perceived to be a loss in intraoperative efficiencies, leading to prolonged cardiopulmonary bypass and perfusion time. Because these indicators are also thought to adversely affec ... Full text Link to item Cite

Association between indices of prosthesis internal orifice size and operative mortality after isolated aortic valve replacement.

Journal Article J Thorac Cardiovasc Surg · April 2007 OBJECTIVES: The appropriate index of prosthesis internal orifice size and its effect on operative mortality after aortic valve replacement are controversial. We examined the association between several relevant indices and patient size on operative mortali ... Full text Link to item Cite

Use of both internal thoracic arteries in diabetic patients increases deep sternal wound infection.

Journal Article Ann Thorac Surg · March 2007 BACKGROUND: Use of both internal thoracic arteries has been limited in diabetic patients fearing an increased incidence of deep sternal wound infection. We analyzed this concern by querying The Society of Thoracic Surgeons Database. METHODS: Diabetic patie ... Full text Link to item Cite

Influence of hospital procedural volume on care process and mortality for patients undergoing elective surgery for mitral regurgitation.

Journal Article Circulation · February 20, 2007 BACKGROUND: Few studies have examined the procedural volume-outcome relationship for heart valve surgery. None have examined process of care factors that may be mediators of this association. METHODS AND RESULTS: This was a retrospective review of outcomes ... Full text Link to item Cite

Bedside tool for predicting the risk of postoperative dialysis in patients undergoing cardiac surgery.

Journal Article Circulation · November 21, 2006 BACKGROUND: Estimation of an individual patient's risk for postoperative dialysis can support informed clinical decision making and patient counseling. METHODS AND RESULTS: To develop a simple bedside risk algorithm for estimating patients' probability for ... Full text Link to item Cite

Contemporary impact of state certificate-of-need regulations for cardiac surgery: an analysis using the Society of Thoracic Surgeons' National Cardiac Surgery Database.

Journal Article Circulation · November 14, 2006 Featured Publication BACKGROUND: Prior research using administrative data associated certificate-of-need (CON) regulation for open heart surgery with higher hospital coronary artery bypass grafting (CABG) volume and lower CABG operative mortality rates in elderly patients. It ... Full text Link to item Cite

Contemporary performance of surgical ventricular restoration procedures: data from the Society of Thoracic Surgeons' National Cardiac Database.

Journal Article Am Heart J · September 2006 BACKGROUND: Surgical ventricular restoration (SVR) is an operation that demonstrates promise to improve outcomes for patients with left ventricular dysfunction. Current use and operative outcomes of SVR have come from centers of expertise, and operative ri ... Full text Link to item Cite

Performance of tests of association in misspecified generalized linear models

Journal Article Journal of Statistical Planning and Inference · September 1, 2006 We examine the effects of modelling errors, such as underfitting and overfitting, on the asymptotic power of tests of association between an explanatory variable x and an outcome in the setting of generalized linear models. The regression function for x is ... Full text Cite

Trends in emergency coronary artery bypass grafting after percutaneous coronary intervention, 1994-2003.

Journal Article Ann Thorac Surg · May 2006 BACKGROUND: In the last decade, percutaneous coronary intervention (PCI) has undergone profound changes in techniques used to achieve revascularization and in patient selection. We examine trends in emergency surgical revascularization after PCI. METHODS: ... Full text Link to item Cite

Determinants of operative mortality in valvular heart surgery.

Journal Article J Thorac Cardiovasc Surg · March 2006 OBJECTIVE: In some respects, outcome reporting in valvular surgery has been hampered by focusing on specific populations, reluctance to publish high-risk subgroups, and possibly skewed or inadequate samples. The goal of this study was to evaluate risk fact ... Full text Link to item Cite

Impact of renal dysfunction on outcomes of coronary artery bypass surgery: results from the Society of Thoracic Surgeons National Adult Cardiac Database.

Journal Article Circulation · February 28, 2006 BACKGROUND: Although patients with end-stage renal disease are known to be at high risk for mortality after coronary artery bypass graft (CABG) surgery, the impact of lesser degrees of renal impairment has not been well studied. The purpose of this study w ... Full text Link to item Cite

Surgical treatment of mitral valve endocarditis in North America.

Journal Article Ann Thorac Surg · December 2005 BACKGROUND: Several single-institution series have suggested the feasibility and effectiveness of mitral valve repair for infective endocarditis (IE). METHODS: We examined 6627 patients with IE undergoing mitral valve surgery at 661 Society of Thoracic Sur ... Full text Link to item Cite

Clinical predictors of major infections after cardiac surgery.

Journal Article Circulation · August 30, 2005 BACKGROUND: Major infections are infrequent but important complications of cardiac surgery. Predicting their occurrence is essential for future prevention. The objective of the current investigation was to create and validate a bedside scoring system to es ... Full text Link to item Cite

Relationship between race and mortality and morbidity after valve replacement surgery.

Journal Article Circulation · March 15, 2005 BACKGROUND: Previous studies have shown that black race is an independent predictor of increased operative mortality after coronary artery bypass surgery. Given the higher incidence of hypertension and hypertension-associated left ventricular hypertrophy i ... Full text Link to item Cite

Bayesian multivariate logistic regression.

Journal Article Biometrics · September 2004 Featured Publication Bayesian analyses of multivariate binary or categorical outcomes typically rely on probit or mixed effects logistic regression models that do not have a marginal logistic structure for the individual outcomes. In addition, difficulties arise when simple no ... Full text Link to item Cite

Cutpoint selection for categorizing a continuous predictor.

Journal Article Biometrics · June 2004 Featured Publication This article presents a new approach for choosing the number of categories and the location of category cutpoints when a continuous exposure variable needs to be categorized to obtain tabular summaries of the exposure effect. The optimum categorization is ... Full text Link to item Cite

Blunt tracheobronchial injuries: treatment and outcomes.

Journal Article Ann Thorac Surg · June 2001 BACKGROUND: Tracheobronchial injury is a recognized, yet uncommon, result of blunt trauma to the thorax. Often the diagnosis and treatment are delayed, resulting in attempted surgical repair months or even years after the injury. This report is an extensiv ... Full text Link to item Cite

The ability of tumor volume to predict relative risks of local failure associated with surgical and non-surgical treatment of supraglottic carcinoma

Journal Article Asian Oceanian Journal of Radiology · April 19, 2001 Introduction: To assess whether tumor volume (TV) can help assess the risk associated with unimodality non-surgical organ preservation therapy in patients with supraglottic carcinoma (SGSCCA). Methods and materials: 100 patients with SGSCCA were treated in ... Cite

Utility of obtaining blood cultures in febrile neutropenic patients undergoing bone marrow transplantation.

Journal Article Bone Marrow Transplant · September 2000 Infection remains an important cause of morbidity and mortality after bone marrow or stem cell transplantation. To evaluate the role of obtaining blood cultures for intermittent or persistent fever in neutropenic patients on antibiotic therapy, we performe ... Full text Link to item Cite

Informing patients of diagnostic mammography results: mammographer's opinions.

Journal Article Acad Radiol · May 2000 PURPOSE: The authors' purpose was to determine mammographers' practices and attitudes regarding disclosing results of diagnostic mammograms to patients. MATERIALS AND METHODS: In 1995, the authors mailed a questionnaire to 500 members of the Society of Bre ... Full text Link to item Cite

The ability of tumor volume to predict local control in surgically treated squamous cell carcinoma of the supraglottic larynx.

Journal Article Head Neck · May 2000 PURPOSE: Pretreatment CT volumetric measurement of the primary tumor has been shown to be a predictor of local control in patients with laryngeal carcinoma treated with radiation therapy (RT) alone. A direct association has been demonstrated between tumor ... Full text Link to item Cite

Thallium-201 single-photon emission CT versus CT for the detection of recurrent squamous cell carcinoma of the head and neck.

Journal Article AJNR Am J Neuroradiol · August 1999 BACKGROUND AND PURPOSE: Thallium-201 single-photon emission computed tomography (SPECT) can be used to detect primary squamous cell carcinoma (SCCA) of the head and neck. Nevertheless, there have very few studies performed to evaluate the ability of thalli ... Link to item Cite

Effects of processing conditions on mammographic image quality.

Journal Article Acad Radiol · August 1999 RATIONALE AND OBJECTIVES: Any given mammographic film will exhibit changes in sensitometric response and image resolution as processing variables are altered. Developer type, immersion time, and temperature have been shown to affect the contrast of the mam ... Full text Link to item Cite

Tumor volume: an independent predictor of outcome for laryngeal cancer.

Journal Article J Comput Assist Tomogr · 1999 PURPOSE: Other studies have shown a relationship between the volume of laryngeal tumors and local control when treated with radiation therapy. Our purpose was to determine the relationship between tumor volume, clinical staging, and several histologic abno ... Full text Link to item Cite

Worldwide Trends in Multi-arterial Coronary Artery Bypass Grafting Surgery 2004-2014: A Tale of 2 Continents.

Journal Article Semin Thorac Cardiovasc Surg Recent evidence shows that multi-arterial coronary artery bypass grafting (MABG) based on bilateral internal thoracic (BITA) or left internal thoracic (LITA) and radial artery (RA) improves long-term outcomes compared with single arterial coronary artery b ... Full text Link to item Cite