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Outcomes for cardiac surgery at Mt. View 2017

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Dr. Poston arrived at Mt View in 2017 as their director of cardiothoracic surgery. The most comprehensive way to understand the performance of his program is to review the quarterly report from STS national cardiac surgery database. This provides risk adjusted outcomes. It shows that compared to the year prior to his arrival, both outcomes and total surgical volume increased.

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Outcomes for cardiac surgery at Mt. View 2017

  1. 1. Major Procedures Mortality CABG, Valve, and Valve+CABG Procedures Combined1 Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of Cases - 33 143 74,094 164,896 Mortality Summary In-hospital Mortality ................................... - 3.0% 1.4% 2.2% 2.0% Operative Mortality ................................... - 3.0% 2.1% 2.9% 2.6% Mortality Risk-Adjustment2 In-hospital Mortality Odds Ratio ............................................ - 1.07 0.79 1.27 1.00 Lower 95% Confidence Limit .............. - 0.44 0.39 1.14 - Upper 95% Confidence Limit .............. - 2.60 1.61 1.41 - O/E Ratio ............................................... - 1.60 0.54 1.10 1.00 Lower 95% Confidence Limit .............. - 0.09 0.01 1.05 - Upper 95% Confidence Limit .............. - 8.13 1.42 1.16 - Risk-adjusted Rate ................................ - 3.1% 1.1% 2.2% 2.0% Operative Mortality Odds Ratio ............................................ - 1.02 0.81 1.30 1.00 Lower 95% Confidence Limit .............. - 0.46 0.42 1.18 - Upper 95% Confidence Limit .............. - 2.26 1.57 1.43 - O/E Ratio ............................................... - 1.24 0.62 1.11 1.00 Lower 95% Confidence Limit .............. - 0.07 0.07 1.08 - Upper 95% Confidence Limit .............. - 6.40 1.42 1.17 - Risk-adjusted Rate ................................ - 3.0% 1.6% 2.8% 2.5% 1 Includes all 7 Major Procedure Categories (CABG, AVR, AVR+CABG, MVR, MVR+CABG, MVP, MVP+CABG) 2 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months Major Procedures -- 7
  2. 2. Major Procedures -- 8
  3. 3. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of Cases - 32 116 54,881 116,231 Demographics Age (years) Mean ..................................................... - 72.7 69.1 65.6 65.6 Median ................................................... - 72.5 70.0 66.0 66.0 25th Percentile ....................................... - 68.5 63.0 59.0 59.0 75th Percentile ....................................... - 78.0 76.0 73.0 73.0 Age >= 65 years old .............................. - 87.5% 66.4% 56.7% 56.5% Gender, Female ........................................ - 9.4% 25.9% 24.5% 24.5% Missing .................................................. - 0.0% 0.0% 0.0% 0.0% Race1 Caucasian ............................................. - 93.8% 97.4% 83.3% 82.7% Black ...................................................... - 0.0% 0.0% 6.6% 7.4% Asian ..................................................... - 0.0% 0.0% 3.7% 3.5% Native American .................................... - 3.1% 2.6% 0.8% 0.6% Native Hawaiian/Pacific Islander ........... - 0.0% 0.0% 0.5% 0.5% Other ..................................................... - 0.0% 1.7% 3.8% 3.4% Multiple Races ....................................... - 0.0% 2.6% 1.2% 0.9% Missing / Not Documented .................... - 3.1% 0.9% 2.5% 2.9% Pt. Declined to Disclose2 ....................... - 3.1% 0.9% 0.5% 0.6% Hispanic or Latino or Spanish Ethnicity .... - 28.1% 36.2% 9.2% 7.4% Missing/ Not Documented ..................... - 6.3% 0.9% 4.1% 4.1% Body Mass Index3 Underweight (BMI < 18.5) ...................... - 0.0% 0.9% 0.7% 0.7% Normal (BMI 18.5 - 24.9) ....................... - 28.1% 18.1% 17.3% 17.7% Overweight (BMI 25.0 - 29.9) ................ - 28.1% 37.1% 37.0% 36.9% Obese I (BMI 30.0 - 34.9) ...................... - 34.4% 31.0% 26.9% 27.0% Obese II (BMI 35.0 - 39.9) ..................... - 9.4% 7.8% 11.7% 11.6% Morbid Obesity (BMI 40.0+) ................... - 0.0% 5.2% 6.3% 6.0% Missing Height ....................................... - 0.0% 0.0% 0.1% 0.1% 1 Data presented in the report represent the individual response rates for each race category Missing Weight ...................................... - 0.0% 0.0% 0.1% 0.1% shown; summing the individual non-caucasian categories will not result in the same rates as shown in the graph since non-caucasian, as defined for the graph, does not include races or ethnicities reported in combination with caucasian 2 Option added in v2.81 3 BMI = Weight(kg) / Height(m)2 CABG -- 9
  4. 4. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Comorbidities Diabetes Mellitus ...................................... - 46.9% 51.7% 49.4% 49.3% Diet Control ........................................ - 0.0% 1.7% 2.9% 2.8% Oral Control ........................................ - 12.5% 14.7% 22.4% 22.3% Insulin Control .................................... - 25.0% 34.5% 18.0% 18.2% Other SQ Medication Control1 ............ - 0.0% 0.0% 0.4% 0.4% Other Control ...................................... - 0.0% 0.0% 0.1% 0.1% Missing Control ................................... - 13.3% 1.7% 0.9% 0.8% Missing .................................................. - 3.1% 0.9% 0.2% 0.2% Hypertension ............................................ - 71.9% 87.9% 89.4% 89.4% Missing .................................................. - 3.1% 0.9% 0.2% 0.2% Dyslipidemia ............................................. - 71.9% 79.3% 89.6% 90.2% Missing .................................................. - 3.1% 3.4% 0.3% 0.3% Family History of CAD .............................. - 50.0% 44.8% 23.3% 20.6% Missing .................................................. - 9.4% 24.1% 4.3% 4.4% Current/Recent Cigarette Smoker ............ - 9.4% 21.6% 22.6% 22.0% Smoker, Current Status Unknown1 ........ - 6.3% 0.9% 0.5% 0.5% Missing .................................................. - 6.3% 11.2% 0.6% 0.6% Chronic Lung Disease Mild ........................................................ - 3.1% 12.9% 10.1% 9.5% Moderate ............................................... - 3.1% 11.2% 5.2% 4.6% Severe ................................................... - 0.0% 6.9% 4.2% 4.0% Unknown Severity1 ................................ - 21.9% 27.6% 7.4% 7.1% Missing .................................................. - 25.0% 16.4% 3.1% 2.7% Congestive Heart Failure .......................... - 3.1% 36.2% 17.7% 18.4% CHF / NYHA Class I2 .......................... - 3.1% 20.7% 1.5% 1.9% CHF / NYHA Class II .......................... - 0.0% 8.6% 5.2% 5.7% CHF / NYHA Class III ......................... - 0.0% 5.2% 7.2% 7.4% CHF / NYHA Class IV ......................... - 0.0% 0.9% 4.2% 4.1% CHF / Missing Class ........................... - 0.0% 2.4% 2.6% 2.6% 1 Option added in v2.81 Missing .................................................. - 0.0% 22.4% 1.2% 1.0% 2 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class Peripheral Arterial Disease ....................... - 3.1% 15.5% 13.9% 13.9% Missing .................................................. - 3.1% 8.6% 0.9% 0.5% CABG -- 10
  5. 5. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Cerebrovascular Disease ......................... - 15.6% 26.7% 21.7% 21.6% Missing ............................................... - 0.0% 0.9% 0.9% 0.8% Coma/Nonresponsive State ................... - 0.0% 1.7% 0.3% 0.2% Missing ............................................... - 0.0% 0.0% 0.9% 1.0% CVD TIA ................................................ - 6.3% 3.4% 4.3% 4.3% Missing ............................................... - 0.0% 6.0% 1.3% 1.1% Carotid Stenosis1 None ................................................... - 87.5% 80.2% 85.9% 86.5% 50-79%2 .............................................. - 0.0% 12.9% 10.0% 9.6% 80-100% ............................................. - 0.0% 5.2% 2.1% 2.1% Missing/Not Documented ................... - 12.5% 1.7% 1.9% 1.8% CVD Prior Carotid Surgery .................... - 9.4% 0.9% 3.4% 3.4% Missing ............................................... - 0.0% 0.9% 1.0% 0.9% Cerebrovascular Accident ..................... - 0.0% 6.9% 7.6% 7.9% Missing ............................................... - 0.0% 4.3% 1.1% 0.9% Renal Failure, Dialysis-Dependent ........... - 0.0% 3.4% 3.2% 3.2% Missing ............................................... - 3.1% 0.9% 0.2% 0.2% Last Creatinine Preop ............................... Mean ..................................................... - 1.0 1.2 1.2 1.2 Median ................................................... - 0.8 0.9 1.0 1.0 25th Percentile ....................................... - 0.8 0.8 0.8 0.8 75th Percentile ....................................... - 1.0 1.2 1.2 1.2 Missing .................................................. - 0.0% 0.0% 0.3% 0.3% Value >= 4.0 mg/dL ............................... - 0.0% 1.7% 2.4% 2.5% Immunosuppressive Treatment ................ - 3.1% 0.0% 3.1% 3.3% Missing ............................................... - 3.1% 2.6% 0.7% 0.5% Previous Interventions 1 Defined as highest level of occlusion in either carotid. Previous Cardiac Surgery3 ....................... - 0.0% 6.9% 2.2% 2.4% 2 Option added in v2.81 First reoperation .................................... - 0.0% 6.9% 2.1% 2.4% 3 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery Previous CABG ........................................ - 0.0% 5.2% 1.6% 1.8% CABG -- 11
  6. 6. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Previous AICD .......................................... - 0.0% 0.9% 1.0% 1.0% Previous Pacemaker ................................. - 0.0% 5.2% 1.7% 1.8% Previous PCI ............................................. - 15.6% 31.0% 30.7% 30.9% <= 6 hours prior to surgery .................... - 0.0% 1.7% 1.1% 0.9% > 6 hours prior to surgery ...................... - 15.6% 29.3% 29.5% 29.9% Missing timing ........................................ - 0.0% 0.0% 0.3% 0.2% Previous PCI Stent ................................... - 100.0% 91.7% 85.9% 87.4% Status Surgery Status Elective .................................................. - 28.1% 43.1% 37.7% 37.4% Urgent .................................................... - 50.0% 53.4% 57.7% 58.5% Emergent ............................................... - 21.9% 3.4% 4.4% 3.9% Emergent Salvage ................................. - 0.0% 0.0% 0.2% 0.2% Missing .................................................. - 0.0% 0.0% 0.0% 0.0% MI .............................................................. - 25.0% 42.2% 54.5% 54.0% <= 7 days prior to surgery .................. - 21.9% 23.3% 31.3% 29.8% 8-21 days prior to surgery .................. - 0.0% 3.4% 5.1% 5.4% >21 days prior to surgery .................... - 3.1% 15.5% 17.9% 18.7% Missing timing ..................................... - 0.0% 0.0% 0.1% 0.1% Missing .................................................. - 0.0% 13.8% 0.9% 0.6% Cardiogenic Shock At the time of surgery ......................... - 15.6% 0.9% 1.5% 1.5% Within 24 hrs of surgery1 .................... - 3.1% 0.9% 0.6% 0.5% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Resuscitation <= 1 hr prior to surgery ........................ - 0.0% 0.0% 0.3% 0.3% 1-24 hrs prior to surgery1 ....................... - 0.0% 0.0% 0.5% 0.4% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% 1 Option added in v2.81 CABG -- 12
  7. 7. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Cardiac Pres. on Admission No Symptoms or Angina ........................ - 3.1% 3.4% 7.7% 7.5% Stable Angina ........................................ - 25.0% 27.6% 14.4% 15.1% Unstable Angina .................................... - 34.4% 31.9% 35.3% 35.8% Non-ST Elevation MI (Non-STEMI) ....... - 21.9% 29.3% 28.9% 27.8% ST Elevation MI (STEMI) ....................... - 6.3% 3.4% 5.6% 5.2% Angina Equivalent1 ................................ - 6.3% 0.9% 3.4% 3.5% Other1 .................................................... - 3.1% 3.4% 4.6% 5.0% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Any Arrhythmia2 ........................................ - 18.8% 18.1% 13.9% 13.9% Recent ................................................... - 18.8% 12.9% 11.3% 11.3% Remote .................................................. - 0.0% 3.4% 2.1% 2.2% Missing .................................................. - 3.1% 3.4% 0.3% 0.3% Ventricular Tachycardia/Fibrillation3 ...... - 3.1% 1.7% 3.2% 3.3% Missing ............................................... - 0.0% 0.0% 0.3% 0.2% 3rd degree Heart Block3 ......................... - 0.0% 1.7% 0.6% 0.6% Missing ............................................... - 0.0% 0.0% 0.4% 0.3% Atrial Fibrillation3, 4 ................................. - 15.6% 8.6% 9.4% 9.4% Missing ............................................... - 0.0% 0.0% 0.3% 0.3% Atrial Flutter3, 4 ....................................... - 0.0% 0.9% 1.1% 1.1% Missing ............................................... - 0.0% 0.0% 0.4% 0.2% Hemodynamics and Catheterization Number of Diseased Coronary Vessels One ........................................................ - 0.0% 4.3% 3.7% 3.8% Two ........................................................ - 31.3% 16.4% 18.9% 19.0% Three ..................................................... - 62.5% 74.1% 76.5% 76.3% Missing .................................................. - 6.3% 5.2% 0.9% 0.8% Left Main Disease (>=50% Stenosis) ........ - 43.8% 32.8% 32.2% 31.5% Missing .................................................. - 50.0% 61.2% 34.5% 37.7% 1 Option added in v2.81 2 Includes VTach/VFib, 2nd and 3rd degree HB, Sick Sinus Syndrome, AFib, and Aflutter 3 For v2.81 data, includes recent or remote arrhythmias 4 For v2.81 data, AFib and AFlutter were separated. CABG -- 13
  8. 8. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Ejection Fraction Mean ..................................................... - 55.6 48.0 52.0 52.1 Median ................................................... - 60.0 50.0 55.0 55.0 25th Percentile ....................................... - 55.0 35.0 45.0 45.0 75th Percentile ....................................... - 60.0 60.0 60.0 60.0 EF missing or not measured .................. - 21.9% 7.8% 3.2% 2.8% EF <40%1 .............................................. - 8.0% 26.2% 15.5% 15.3% Pulmonary Hypertension2 ......................... - 50.0% 39.2% 34.9% 34.0% PA mean/systolic pressure missing or not measured .................................... - 93.8% 56.0% 66.6% 68.3% Aortic Stenosis .......................................... - 0.0% 5.2% 3.6% 3.5% Missing .................................................. - - 0.0% 0.2% 0.1% Mitral Insufficiency Trivial ..................................................... - 6.3% 23.3% 26.2% 29.1% Mild ........................................................ - 0.0% 27.6% 25.8% 25.7% Moderate ............................................... - 6.3% 10.3% 6.4% 6.5% Severe ................................................... - 0.0% 0.0% 0.5% 0.5% Missing/Not Documented ...................... - - 0.0% 0.5% 0.6% Preoperative Medications Aspirin ....................................................... - 78.1% 68.1% 84.6% 84.4% Among Eligible Cases ........................... - 78.1% 69.9% 85.3% 85.1% Contraindicated / Not Indicated ............. - 0.0% 2.6% 0.8% 0.8% Missing .................................................. - 0.0% 3.4% 0.8% 0.7% Inotropics .................................................. - 6.3% 1.7% 1.4% 1.2% Missing .................................................. - 0.0% 0.0% 0.3% 0.2% Beta Blockers ........................................... - 46.9% 61.2% 88.6% 89.5% Among Eligible Cases ........................... - 45.8% 64.2% 94.2% 95.3% Contraindicated / Not Indicated ............. - 3.1% 6.0% 5.2% 5.5% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% 1 Among patients with measured EF 2 PA systolic pressure > 35mmHg Steroids .................................................... - 6.3% 5.2% 2.0% 2.0% Among Eligible Cases ........................... - 6.3% 5.2% 2.1% 2.0% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.0% 0.0% Missing .................................................. - 0.0% 0.0% 0.4% 0.4% CABG -- 14
  9. 9. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Nitrates IV ................................................. - 21.9% 12.1% 9.2% 8.7% Missing .................................................. - 0.0% 0.0% 0.4% 0.4% ACE Inhibitors ........................................... - 40.6% 24.1% 42.7% 40.4% Among Eligible Cases ........................... - 40.6% 25.0% 43.5% 41.1% Contraindicated / Not Indicated ............. - 0.0% 3.4% 1.9% 1.7% Missing .................................................. - 0.0% 0.9% 0.8% 0.8% Anticoagulants .......................................... - 62.5% 42.2% 43.4% 43.8% Missing .................................................. - 0.0% 0.0% 0.4% 0.4% Coumadin1 ................................................ - 0.0% 0.0% 0.3% 0.3% Missing .................................................. - 0.0% 0.0% 0.5% 0.5% Coumadin w/in 5 Days2 ............................ - - 2.2% 0.5% 0.4% Among Eligible Cases ........................... - - 2.2% 0.5% 0.4% Contraindicated / Not Indicated ............. - - 0.0% 0.1% 0.1% Missing .................................................. - - 0.0% 0.9% 0.7% Lipid-Lowering agents ............................... - 68.8% 37.1% 78.8% 79.0% Among Eligible Cases ........................... - 68.8% 37.1% 79.8% 80.1% Contraindicated / Not Indicated ............. - 0.0% 0.0% 1.3% 1.3% Missing .................................................. - 3.1% 0.9% 0.8% 0.8% Glycoprotein IIb/IIIa Inhibitor ..................... - 6.3% 0.9% 1.6% 1.3% Missing .................................................. - 3.1% 0.0% 0.4% 0.4% ADP Inhibitors within 5 Days .................... - 3.1% 16.4% 9.0% 9.4% Among Eligible Cases ........................... - 3.1% 16.4% 9.0% 9.5% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.1% 0.2% Missing .................................................. - 3.1% 1.7% 0.4% 0.5% ADP Inhibitor Discontinuation3 < 1 Day ............................................... - 0.0% 5.3% 14.1% 14.3% 1 Day .................................................. - 0.0% 42.1% 15.5% 17.0% 2 Days ................................................ - 0.0% 31.6% 17.4% 17.6% 1 Variable dropped in v2.9 3 Days ................................................ - 0.0% 0.0% 19.0% 19.3% 2 Variable added in v2.9 4 Days ................................................ - 0.0% 21.1% 20.2% 19.4% 3 Excludes patients not on ADP Inhibitors within 5 Days 5 Days ................................................ - 100.0% 0.0% 12.4% 11.4% Missing .................................................. - 0.0% 0.0% 1.3% 0.9% CABG -- 15
  10. 10. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Antiplatelets within 5 Days1 ...................... - 0.0% 0.0% 4.2% 3.5% Among Eligible Cases ........................... - 0.0% 0.0% 4.2% 3.5% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.1% 0.2% Missing .................................................. - 0.0% 1.4% 0.5% 0.5% Operative Information Blood Products Used ................................ - 75.0% 26.7% 26.5% 25.8% Number of Blood Product Units Used 1 Red Blood Cell Unit ......................... - 18.8% 6.0% 5.6% 6.0% 2 Red Blood Cell Units ....................... - 18.8% 6.0% 7.7% 7.2% 3 Red Blood Cell Units ....................... - 3.1% 5.2% 2.7% 2.4% 4+ Red Blood Cell Units ..................... - 21.9% 3.4% 2.6% 2.4% 1+ Fresh Frozen Plasma Units ........... - 40.6% 13.8% 7.6% 6.8% 1+ Cryoprecipitate Units ..................... - 6.3% 6.9% 2.5% 2.6% 1+ Platelet Units ................................. - 37.5% 12.1% 13.7% 13.2% Missing .................................................. - 0.0% 0.0% 0.7% 0.7% Number of Distal Anastamoses, Total 1 ............................................................ - 9.4% 33.6% 5.0% 5.3% 2 ............................................................ - 25.0% 24.1% 17.6% 17.7% 3 ............................................................ - 50.0% 23.3% 39.7% 40.0% 4 ............................................................ - 15.6% 15.5% 28.0% 27.8% 5+ .......................................................... - 0.0% 3.4% 9.4% 9.0% Missing2 ................................................. - 0.0% 0.0% 0.1% 0.1% Vein Harvest Technique3 Endovascular/Endoscopic ..................... - 100.0% 94.9% 89.9% 91.2% Direct Vision .......................................... - 0.0% 3.4% 8.4% 7.2% Both ....................................................... - 0.0% 1.7% 1.5% 1.3% Cryopreserved ....................................... - 0.0% 0.0% 0.1% 0.0% Missing ............................................... - 0.0% 0.0% 0.2% 0.2% Internal Mammary Artery Used4 Any ........................................................ - 93.8% 100.0% 98.8% 99.0% Left ..................................................... - 84.4% 67.3% 93.2% 93.1% Right ................................................... - 0.0% 2.7% 0.4% 0.4% 1 Variable dropped in v2.9 Both .................................................... - 9.4% 30.0% 4.8% 5.0% 2 Where number of arterial conduits and number of vein grafts both missing Missing .................................................. - 0.0% 0.0% 0.1% 0.1% 3 Where at least 1 vein was harvested 4 Excludes patients with prior CABG surgery CABG -- 16
  11. 11. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Radial Artery Used ................................... - 0.0% 0.0% 4.8% 5.0% Missing .................................................. - 0.0% 0.0% 0.5% 0.5% Radial Artery Harvest Technique ........... Endovascular/Endoscopic .................. - - - 45.9% 43.1% Direct Vision ....................................... - - - 49.3% 53.1% Both .................................................... - - - 0.8% 0.5% Missing ............................................... - - - 4.0% 3.3% IABP Used ................................................ - 25.0% 16.4% 9.8% 9.1% Preop .................................................. - 18.8% 15.5% 7.4% 6.7% Intraop ................................................ - 6.3% 0.0% 2.1% 2.0% Postop ................................................ - 0.0% 0.9% 0.4% 0.4% Missing Timing ................................... - 0.0% 0.0% 0.0% 0.0% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% Robotic Technology Assisted ................... - 6.3% 50.9% 0.6% 1.0% Missing .................................................. - 0.0% 0.0% 0.3% 0.7% Off-pump Procedure (see following section for detail) ................................... - 34.4% 44.0% 13.2% 12.5% Cross-Clamp Time (min) Mean ..................................................... - 75.6 - 71.1 69.2 Median ................................................... - 77.0 - 66.0 65.0 25th Percentile ....................................... - 51.0 - 49.0 48.0 75th Percentile ....................................... - 94.0 - 88.0 86.0 Cardiopulmonary Bypass Time (min) Mean ..................................................... - 110.8 53.2 97.3 94.7 Median ................................................... - 111.0 49.0 92.0 89.0 25th Percentile ....................................... - 84.0 37.0 71.0 69.0 75th Percentile ....................................... - 125.0 64.0 118.0 114.0 CABG -- 17
  12. 12. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Circulatory Arrest ...................................... - 0.0% 0.0% 0.4% 0.3% Missing .................................................. - 0.0% 0.0% 0.1% 0.3% Circulatory Arrest Time (min) Mean ..................................................... - - - 10.8 11.3 Median ................................................... - - - 4.0 5.0 25th Percentile ....................................... - - - 0.0 0.0 75th Percentile ....................................... - - - 9.0 11.0 Skin Incision Duration (min) Mean ..................................................... - 261.4 230.9 240.0 235.7 Median ................................................... - 237.0 219.0 231.0 227.0 25th Percentile ....................................... - 200.0 189.0 187.0 183.0 75th Percentile ....................................... - 269.0 263.0 282.0 278.0 OR Duration (min) Mean ..................................................... - 348.1 327.3 320.2 315.5 Median ................................................... - 316.0 309.0 310.0 305.0 25th Percentile ....................................... - 274.0 281.0 260.0 255.0 75th Percentile ....................................... - 351.5 353.0 369.0 364.0 Antibiotic Selection1, 2 ............................... - 100.0% 100.0% 99.4% 99.4% Exclusions ............................................. - 0.0% 0.0% 0.7% 0.7% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% Antibiotic Timing1, 3 ................................... - 100.0% 100.0% 99.0% 98.9% Exclusions ............................................. - 0.0% 0.0% 0.4% 0.4% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% Antibiotics Discontinued1,4 ........................ - 100.0% 99.1% 99.0% 99.1% Exclusions ............................................. - 0.0% 0.0% 1.4% 1.1% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% Clotting Agents5 ........................................ - 3.1% 19.8% 84.5% 84.0% Missing .................................................. - 0.0% 0.0% 0.4% 0.9% 1 All antibiotic measures are calculated among patients without exclusions 2 First or second generation cephalosporin prescribed/given prophylactically 3 Appropriate timing of prophylactic antibiotics 4 Prophylactic antibiotics discontinued within 48 hours 5 Includes one or more of the following: Aprotinin, Epsilon Amino-Caproic Acid, Desmopressin, or Tranexamic Acid CABG -- 18
  13. 13. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Postoperative Information Blood Products Used ................................ - 65.6% 37.1% 29.8% 28.7% Number of Blood Product Units Used 1 Red Blood Cell Unit ......................... - 15.6% 12.1% 10.0% 10.0% 2 Red Blood Cell Units ....................... - 28.1% 10.3% 9.4% 8.5% 3 Red Blood Cell Units ....................... - 12.5% 5.2% 3.0% 2.9% 4+ Red Blood Cell Units ..................... - 9.4% 7.8% 5.0% 4.8% 1+ Fresh Frozen Plasma Units ........... - 9.4% 6.0% 6.6% 6.2% 1+ Cryoprecipitate Units ..................... - 3.1% 5.2% 2.9% 3.2% 1+ Platelet Units ................................. - 3.1% 8.6% 7.2% 7.2% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Intraop/Postop Products Used .................. - 87.5% 44.0% 42.5% 41.3% Total Number of Blood Product Units 1 Red Blood Cell Unit ......................... - 12.5% 7.8% 9.5% 9.8% 2 Red Blood Cell Units ....................... - 18.8% 10.3% 11.7% 10.8% 3 Red Blood Cell Units ....................... - 18.8% 8.6% 5.2% 5.0% 4+ Red Blood Cell Units ..................... - 37.5% 12.9% 10.0% 9.4% 1+ Fresh Frozen Plasma Units ........... - 40.6% 16.4% 12.6% 11.6% 1+ Cryoprecipitate Units ..................... - 6.3% 8.6% 5.1% 5.5% 1+ Platelet Units ................................. - 37.5% 15.5% 18.5% 18.0% Missing .................................................. - 0.0% 0.0% 0.0% 0.0% Ventilation Total Ventilation Hours Mean .................................................. - 28.2 9.0 17.1 16.8 Median ............................................... - 8.7 5.3 5.7 5.7 25th Percentile .................................... - 5.8 0.5 3.8 3.9 75th Percentile .................................... - 18.8 10.8 10.9 10.3 Initial Ventilation Hours Mean .................................................. - 18.9 7.5 12.1 11.8 Median ............................................... - 8.1 5.1 5.6 5.6 Initial Ventilation <6 hours .................. - 25.0% 58.6% 54.3% 54.8% Extubated in OR .................................... - 3.1% 25.0% 2.8% 2.3% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% Reintubation .......................................... - 6.3% 5.2% 3.8% 3.5% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% CABG -- 19
  14. 14. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Additional Ventilation Hours1 Mean .................................................. - 144.0 29.2 131.7 141.2 Median ............................................... - 144.0 14.5 64.0 66.2 ICU Stay Total ICU Hours Mean .................................................. - 134.8 142.3 77.9 72.3 Median ............................................... - 120.3 121.5 51.7 48.0 75th Percentile .................................... - 93.4 96.3 29.1 26.0 25th Percentile .................................... - 142.7 164.2 93.5 81.0 Initial ICU Hours Mean .................................................. - 134.8 141.1 74.8 68.9 Median ............................................... - 120.3 121.3 51.0 47.6 Readmitted to ICU ................................. - 0.0% 0.9% 2.5% 2.8% Additional ICU Hours2 Mean .................................................. - - 144.0 124.4 123.9 Median ............................................... - - 144.0 71.1 70.7 Mortality Summary In-hospital Mortality ................................... - 3.1% 0.9% 1.9% 1.7% Operative Mortality ................................... - 3.1% 1.7% 2.5% 2.3% Mortality Risk-Adjustment3 In-hospital Mortality Odds Ratio ............................................ - 1.08 0.80 1.20 1.00 Lower 95% Confidence Limit .............. - 0.43 0.39 1.06 - Upper 95% Confidence Limit .............. - 2.68 1.64 1.36 - O/E Ratio ............................................... - 1.63 0.40 1.08 1.00 Lower 95% Confidence Limit .............. - 0.09 0.02 1.02 - Upper 95% Confidence Limit .............. - 7.79 2.12 1.15 - Risk-adjusted Rate ................................ - 2.7% 0.7% 1.9% 1.7% 1 Among patients reintubated 2 Among patients readmitted to the ICU 3 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG -- 20
  15. 15. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Operative Mortality Odds Ratio ............................................ - 1.02 0.83 1.21 1.00 Lower 95% Confidence Limit .............. - 0.45 0.42 1.08 - Upper 95% Confidence Limit .............. - 2.31 1.64 1.35 - O/E Ratio ............................................... - 1.26 0.61 1.09 1.00 Lower 95% Confidence Limit .............. - 0.07 0.11 1.03 - Upper 95% Confidence Limit .............. - 6.05 2.07 1.14 - Risk-adjusted Rate ................................ - 2.7% 1.4% 2.5% 2.3% Complications Summary Any Complications .................................... - 43.8% 52.6% 38.6% 38.9% Any Major Complications / Operative Mortality ................................................. - 21.9% 12.9% 12.9% 12.0% Operative Complications Any Reoperation .................................... - 0.0% 2.6% 3.6% 3.7% Any Reoperation (NQF Definition)1 ........ - 0.0% 1.7% 2.4% 2.4% Reoperation for Bleeding ....................... - 0.0% 1.7% 1.7% 1.7% Reoperation for Valvular Dysfunction2 ... - 0.0% 0.0% 0.0% 0.0% Reoperation for Graft Occlusion2 ........... - 0.0% 0.0% 0.3% 0.3% Aortic Reintervention3 ............................ - - 0.0% 0.0% 0.0% Reoperation for Other Cardiac .............. - 0.0% 0.0% 0.4% 0.4% Reoperation for Other Non-Cardiac ....... - 0.0% 0.9% 1.4% 1.5% Infection Complications Any Infection .......................................... - 12.5% 15.5% 2.4% 2.3% Deep Sternal Infection/Mediastinitis ...... - 0.0% 0.0% 0.3% 0.3% Septicemia/Sepsis ................................. - 0.0% 1.7% 0.9% 0.9% Conduit Harvest or Cannulation Site4 .... - 12.5% 6.9% 0.5% 0.5% 1 Includes reoperations for bleeding/tamponade, valvular dysfunction, graft occlusion, and other cardiac problems. 2 Includes surgical and PCI/Transcatheter interventions 3 Variable added in 2.9 4 Excludes patients with zero vein grafts 5 Variable dropped in 2.9 CABG -- 21
  16. 16. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Neurological Complications Any Neurological ................................... - 9.4% 12.1% 3.1% 3.0% Coma/Encephalopathy1 ......................... - 9.4% 4.3% 1.8% 1.6% Coma2 ................................................... - - 0.0% 1.3% 1.3% Encephalopathy2 ................................... - - 0.0% 0.2% 0.2% Permanent Stroke .................................. - 0.0% 0.0% 1.4% 1.4% Transient Ischemic Attack ..................... - 0.0% 0.9% 0.2% 0.2% Paralysis ................................................ - 0.0% 0.0% 0.2% 0.1% Pulmonary Complications Any Pulmonary ...................................... - 25.0% 16.4% 12.6% 12.1% Prolonged Ventilation ............................ - 18.8% 10.3% 8.2% 7.5% Pneumonia ............................................ - 9.4% 2.6% 2.7% 2.4% Pulmonary Embolism ............................. - 0.0% 0.0% 0.2% 0.2% Pleural Effusion Requiring Drainage ...... - 3.1% 4.3% 3.3% 3.6% Renal Complications Renal Failure3 ........................................ - 0.0% 0.9% 2.4% 2.1% Vascular Complications Any Vascular ......................................... - 0.0% 0.9% 0.3% 0.4% Acute Limb Ischemia ............................. - 0.0% 0.9% 0.3% 0.4% Other Complications Any Other .............................................. - 28.1% 28.4% 29.9% 30.5% New Onset Atrial Fibrillation4 ................. - 33.3% 26.4% 24.6% 25.0% Recent Recurrent Atrial Fibrillation5 ....... - 0.0% 0.0% 26.6% 26.9% Cardiac Arrest ....................................... - 3.1% 3.4% 2.1% 1.9% Anticoagulant Complication ................... - 0.0% 0.0% 0.6% 0.5% Tamponade ........................................... - 0.0% 0.0% 0.1% 0.1% Gastro-Intestinal Complication .............. - 0.0% 0.0% 2.1% 2.1% Multi-System Failure .............................. - 0.0% 0.0% 0.7% 0.6% 1 Variable dropped in 2.9 2 Variable added in 2.9 3 Excludes patients with preoperative dialysis or last creatinine >=4 4 New Onset Afib is only among patients with no history of arrhythmias 5 Recent Recurrent Afib is among patients with history of recent Afib CABG -- 22
  17. 17. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Complications Risk-Adjustment1 Major Complications or Op. Mortality Odds Ratio ............................................ - 1.24 0.87 1.07 1.00 Lower 95% Confidence Limit .............. - 0.66 0.55 0.99 - Upper 95% Confidence Limit .............. - 2.32 1.37 1.15 - O/E Ratio ............................................... - 1.51 0.87 1.06 1.00 Lower 95% Confidence Limit .............. - 0.70 0.53 1.04 - Upper 95% Confidence Limit .............. - 2.60 1.33 1.08 - Risk-adjusted Rate ................................ - 18.3% 10.5% 12.7% 12.0% Any Reoperation Odds Ratio ............................................ - 0.82 0.86 0.90 1.00 Lower 95% Confidence Limit .............. - 0.38 0.49 0.82 - Upper 95% Confidence Limit .............. - 1.76 1.51 0.97 - O/E Ratio ............................................... - 0.00 0.63 0.97 1.00 Lower 95% Confidence Limit .............. - 0.00 0.16 0.94 - Upper 95% Confidence Limit .............. - 2.54 1.77 1.02 - Risk-adjusted Rate ................................ - 0.0% 2.3% 3.6% 3.7% Deep Sternal Infection/Mediastinitis Odds Ratio ............................................ - 0.97 0.84 0.84 1.00 Lower 95% Confidence Limit .............. - 0.26 0.22 0.66 - Upper 95% Confidence Limit .............. - 3.64 3.18 1.05 - O/E Ratio ............................................... - 0.00 0.00 0.92 1.00 Lower 95% Confidence Limit .............. - 0.00 0.00 0.82 - Upper 95% Confidence Limit .............. - 33.75 6.92 1.11 - Risk-adjusted Rate ................................ - 0.0% 0.0% 0.3% 0.3% Permanent Stroke Odds Ratio ............................................ - 0.94 0.86 0.96 1.00 Lower 95% Confidence Limit .............. - 0.43 0.48 0.86 - Upper 95% Confidence Limit .............. - 2.05 1.56 1.07 - O/E Ratio ............................................... - 0.00 0.00 1.00 1.00 Lower 95% Confidence Limit .............. - 0.00 0.00 0.94 - Upper 95% Confidence Limit .............. - 7.65 2.28 1.08 - Risk-adjusted Rate ................................ - 0.0% 0.0% 1.4% 1.4% 1 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG -- 23
  18. 18. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Renal Failure Odds Ratio ............................................ - 0.82 0.76 1.23 1.00 Lower 95% Confidence Limit .............. - 0.30 0.31 1.09 - Upper 95% Confidence Limit .............. - 2.19 1.85 1.40 - O/E Ratio ............................................... - 0.00 0.41 1.12 1.00 Lower 95% Confidence Limit .............. - 0.00 0.02 1.07 - Upper 95% Confidence Limit .............. - 4.48 2.14 1.19 - Risk-adjusted Rate ................................ - 0.0% 0.9% 2.4% 2.1% Prolonged Ventilation Odds Ratio ............................................ - 1.54 1.05 1.11 1.00 Lower 95% Confidence Limit .............. - 0.71 0.60 1.01 - Upper 95% Confidence Limit .............. - 3.33 1.82 1.23 - O/E Ratio ............................................... - 1.91 1.05 1.07 1.00 Lower 95% Confidence Limit .............. - 0.82 0.59 1.05 - Upper 95% Confidence Limit .............. - 3.47 1.69 1.11 - Risk-adjusted Rate ................................ - 15.1% 7.9% 8.1% 7.5% Discharge Location1 Home ..................................................... - 48.4% 62.6% 75.8% 78.3% Extended Care/TCU .............................. - 51.6% 33.9% 19.7% 17.7% Other Acute Care Hospital ..................... - 0.0% 0.9% 0.8% 0.6% Nursing Home ....................................... - 0.0% 2.6% 3.1% 2.7% Hospice ................................................. - 0.0% 0.0% 0.1% 0.1% Left AMA2 .............................................. - 0.0% 0.0% 0.1% 0.1% Other ..................................................... - 0.0% 0.0% 0.3% 0.3% Missing .................................................. - 0.0% 0.0% 0.2% 0.3% Discharge Medications1 Aspirin ....................................................... - 83.9% 87.0% 96.8% 97.1% Among Eligible Cases ........................... - 83.9% 90.9% 98.0% 98.3% Contraindicated / Not Indicated ............. - 0.0% 4.3% 1.3% 1.2% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% ACE inhibitors ........................................... - 83.9% 52.2% 38.4% 35.4% 1 Excludes in-hospital mortalities Among Eligible Cases ........................... - 86.7% 80.0% 65.6% 61.6% 2 Option added in v2.81 Contraindicated / Not Indicated ............. - 3.2% 34.8% 41.5% 42.6% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% CABG -- 24
  19. 19. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Beta Blockers ........................................... - 90.3% 92.2% 94.1% 94.5% Among Eligible Cases ........................... - 90.3% 93.8% 98.0% 98.5% Contraindicated / Not Indicated ............. - 0.0% 1.7% 3.9% 4.0% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Statin Lipid-Lowering Agents .................... - 93.5% 81.7% 94.3% 94.4% Among Eligible Cases ........................... - 93.5% 83.9% 97.5% 97.8% Contraindicated / Not Indicated ............. - 0.0% 2.6% 3.3% 3.4% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Non-Statin Lipid-Lowering Agents ............ - 0.0% 2.6% 10.3% 10.5% Among Eligible Cases ........................... - 0.0% 2.6% 10.3% 10.6% Contraindicated / Not Indicated ............. - 3.2% 0.0% 0.5% 0.7% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% ADP Inhibitors ........................................... - 12.9% 13.0% 14.4% 13.9% Among Eligible Cases ........................... - 12.9% 13.0% 14.5% 14.0% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.5% 0.8% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% P2Y12 Antagonists1 .................................. - 38.7% 17.1% 30.6% 31.9% Among Eligible Cases ........................... - 38.7% 17.1% 30.8% 32.3% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.8% 1.2% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Other Antiplatelets .................................... - 0.0% 1.7% 1.4% 1.1% Among Eligible Cases ........................... - 0.0% 1.7% 1.4% 1.1% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.2% 0.6% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% Amiodarone .............................................. - 35.5% 32.2% 34.7% 32.9% Among Eligible Cases ........................... - 35.5% 32.5% 34.9% 33.3% Contraindicated / Not Indicated ............. - 0.0% 0.9% 0.7% 1.0% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% Coumadin ................................................. - 0.0% 0.9% 6.6% 7.2% 1 Variable dropped in v2.9 Among Eligible Cases ........................... - 0.0% 0.9% 6.6% 7.3% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.3% 0.6% Missing .................................................. - 0.0% 0.0% 0.2% 0.2% CABG -- 25
  20. 20. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Discharge Referrals/Counseling1 Cardiac Rehabilitation Referral ................. - 93.5% 93.0% 89.5% 89.6% Missing .................................................. - 0.0% 0.0% 0.3% 0.2% Smoking Cessation Counseling ................ - 44.4% 92.9% 89.0% 90.8% Missing .................................................. - 0.0% 0.0% 0.7% 0.7% 1 Excludes in-hospital mortalities and Not Applicable Records CABG -- 26
  21. 21. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Readmission and Reason1 Readmitted within 30 days2 ................... - 16.1% 15.7% 10.6% 10.1% Anticoagulation Complication Valvular ........................................... - 0.0% - - - Pharmacological .............................. - 0.0% 0.9% 0.1% 0.1% Arryhthmia/Heart Block ...................... - 0.0% 1.7% 0.8% 0.9% Congestive Heart Failure .................... - 0.0% 1.7% 1.2% 1.1% MI and/or Recurrent Angina ............... - 0.0% 0.0% 0.3% 0.3% Pericardial Effusion / Tamponade ...... - 0.0% 0.0% 0.2% 0.2% Pneumonia3 ........................................ - 6.5% 0.9% 0.5% 0.5% Respiratory Complications, Other3 ..... - 3.2% 1.7% 0.4% 0.3% Pleural Effusion req. Intervention3 ...... - 0.0% 0.0% 0.8% 0.8% Coronary Artery Dysfunction .............. - 0.0% 0.0% 0.1% 0.1% Valve Dysfunction ............................... - 0.0% 0.0% 0.0% 0.0% Infection - Deep Sternum ................... - 0.0% 0.0% 0.3% 0.4% Infection - Conduit Harvest Site .......... - 0.0% 0.9% 0.3% 0.2% Renal failure ....................................... - 0.0% 0.0% 0.1% 0.1% TIA / Permanent CVA ......................... - 0.0% 0.9% 0.3% 0.3% Acute Vascular Complication ............. - 0.0% 0.0% 0.1% 0.1% Subacute Endocarditis ....................... - 0.0% 0.0% 0.0% 0.0% VAD Complication .............................. - - 0.0% - - Transplant Rejection .......................... - - 0.0% 0.0% 0.0% DVT .................................................... - 0.0% 0.0% 0.1% 0.1% PE ...................................................... - 0.0% 0.0% 0.5% 0.4% Angina4 ............................................... - - 0.0% 0.3% 0.3% Aortic Complication4 ........................... - - 0.0% 0.0% 0.0% Blood Pressure4 ................................. - - 0.0% 0.3% 0.3% Chest Pain, noncardiac4 ..................... - - 0.0% 0.4% 0.3% Depression/psychiatric issue4 ............. - - 0.0% 0.0% 0.0% Electrolyte imbalance4 ........................ - - 0.0% 0.1% 0.1% Failure to Thrive4 ................................ - - 0.0% 0.0% 0.0% GI Issue4 ............................................. - - 0.0% 0.6% 0.6% Mental Status Changes4 ..................... - - 0.0% 0.1% 0.1% Pericarditis/Post Cardiotomy Syndr.4 . - - 0.0% 0.0% 0.0% Renal Insufficency4 ............................. - - 0.0% 0.0% 0.0% Sepsis4 ............................................... - - 2.2% 0.3% 0.2% 1 Excludes in-hospital mortalities Transfusion4 ....................................... - - 0.0% 0.1% 0.0% 2 Timed from discharge for v2.81 Wound, other4 .................................... - - 2.2% 0.5% 0.6% 3 Option added in v2.81 Other .................................................. - 6.5% 5.2% 3.3% 3.2% 4 Option added in v2.9 Other - Planned readmission3 ............ - 0.0% 0.0% 0.1% 0.1% Missing/Unknown .................................. - 0.0% 0.0% 3.5% 3.8% CABG -- 27
  22. 22. Isolated CABG Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Length of Stay Summary Total Length of Stay (days) Mean ..................................................... - 8.8 9.2 9.4 9.3 Median ................................................... - 7.0 8.0 8.0 8.0 25th Percentile ....................................... - 6.0 5.5 6.0 6.0 75th Percentile ....................................... - 9.0 11.0 11.0 11.0 Post-Procedure Length of Stay (days) Mean ..................................................... - 7.1 6.8 6.9 6.9 Median ................................................... - 6.0 6.0 6.0 6.0 25th Percentile ....................................... - 5.0 4.0 5.0 5.0 75th Percentile ....................................... - 7.0 8.0 7.0 7.0 PLOS <6 days ....................................... - 31.3% 47.4% 46.2% 46.9% PLOS >14 days ..................................... - 3.1% 5.2% 5.0% 5.0% Length of Stay Risk-Adjustment1 Short stay: PLOS <6 days Odds Ratio ............................................ - 0.75 1.56 1.09 1.00 Lower 95% Confidence Limit .............. - 0.37 1.06 0.96 - Upper 95% Confidence Limit .............. - 1.51 2.29 1.24 - O/E Ratio ............................................... - 0.79 1.26 0.99 1.00 Lower 95% Confidence Limit .............. - 0.43 1.02 0.98 - Upper 95% Confidence Limit .............. - 1.21 1.48 0.99 - Risk-adjusted Rate ................................ - 37.1% 58.9% 46.4% 46.9% Long stay: PLOS >14 days Odds Ratio ............................................ - 0.87 0.88 0.88 1.00 Lower 95% Confidence Limit .............. - 0.37 0.47 0.80 - Upper 95% Confidence Limit .............. - 2.05 1.65 0.97 - O/E Ratio ............................................... - 0.56 0.76 0.99 1.00 Lower 95% Confidence Limit .............. - 0.03 0.32 0.96 - Upper 95% Confidence Limit .............. - 2.71 1.53 1.03 - Risk-adjusted Rate ................................ - 2.8% 3.8% 4.9% 5.0% 1 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG -- 28
  23. 23. Isolated CABG Procedures Subset: On-pump procedures Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of On-Pump Procedures - 21 65 47,643 101,632 Demographics Age (years), median .............................. - 72.0 70.0 66.0 66.0 Gender, Female ..................................... - 9.5% 23.1% 24.1% 24.1% Race, Non-caucasian ............................ - 4.8% 3.1% 16.8% 17.2% Multiple Races ....................................... - 0.0% 3.1% 1.1% 0.9% Obesity (BMI 30.0+) .............................. - 38.1% 49.2% 45.1% 44.8% Comorbidities Diabetes Mellitus ................................... - 47.6% 44.6% 49.4% 49.4% Insulin-Dependent .............................. - 23.8% 26.2% 17.9% 18.2% Hypertension ......................................... - 81.0% 83.1% 89.2% 89.3% Dyslipidemia .......................................... - 81.0% 83.1% 89.4% 90.1% Current/Recent Cigarette Smoker ......... - 4.8% 23.1% 22.8% 22.1% Chronic Lung Disease, Mild+ ................. - 0.0% 27.7% 19.2% 17.8% Congestive Heart Failure ....................... - 4.8% 32.3% 17.9% 18.6% CHF / NYHA class IV1 ........................ - 0.0% 0.0% 4.3% 4.1% Peripheral Arterial Disease .................... - 0.0% 9.2% 13.6% 13.6% Cerebrovascular Disease ...................... - 9.5% 26.2% 21.5% 21.4% CVA .................................................... - 0.0% 6.2% 7.4% 7.7% Renal failure, Dialysis-Dependent ......... - 0.0% 3.1% 3.2% 3.1% Last Creatinine Preop >= 4.0 mg/dl ....... - 0.0% 1.5% 2.3% 2.5% Immunosuppressive Treatment ............. - 4.8% 0.0% 3.0% 3.2% Previous Interventions Previous Cardiac Surgery2 .................... - 0.0% 9.2% 2.1% 2.4% Previous CAB ..................................... - 0.0% 7.7% 1.5% 1.8% Previous PCI ......................................... - 9.5% 30.8% 30.4% 30.6% Status Surgery status, Emergent or Salvage .... - 28.6% 4.6% 4.7% 4.2% MI .......................................................... - 28.6% 41.5% 54.6% 54.3% <= 7 days Prior to Surgery ................. - 23.8% 23.1% 31.6% 30.2% Cardiogenic Shock ................................ - 19.0% 1.5% 1.6% 1.6% Resuscitation ......................................... - 0.0% 0.0% 0.3% 0.3% 1 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class 2 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG On-pump procedures -- 29
  24. 24. Isolated CABG Procedures Subset: On-pump procedures Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Hemodynamics and Catheterization Triple Vessel Disease ............................ - 61.9% 78.5% 78.2% 78.1% Left Main Disease (>=50% stenosis) ..... - 38.1% 35.4% 32.5% 31.9% Ejection Fraction < 40%1 ....................... - 12.5% 25.0% 15.6% 15.5% Aortic Stenosis ...................................... - 0.0% 4.6% 3.5% 3.5% Mitral Insufficiency, Mild+ ...................... - 4.8% 33.8% 32.8% 32.8% Operative Information IABP, Preoperative ................................ - 28.6% 20.0% 7.6% 6.9% Cross-Clamp Time (min) Mean .................................................. - 75.6 - 71.1 69.2 Median ............................................... - 77.0 - 66.0 65.0 Cardiopulmonary Bypass Time (min) Mean .................................................. - 110.8 53.2 97.3 94.7 Median ............................................... - 111.0 49.0 92.0 89.0 Postoperative Information Ventilation hours, total Mean .................................................. - 36.9 11.1 17.7 17.3 Median ............................................... - 11.7 7.6 5.8 5.8 ICU hours, total Mean .................................................. - 143.7 149.6 78.9 73.3 Median ............................................... - 117.2 120.2 52.0 48.2 Mortality Summary & Risk-Adjustment2 In-hospital Mortality Observed rate ..................................... - 4.8% 0.0% 2.0% 1.8% Risk-adjusted rate .............................. - 3.2% 0.0% 1.6% 1.5% Operative Mortality Observed rate ..................................... - 4.8% 0.0% 2.6% 2.3% Risk-adjusted rate .............................. - 3.5% 0.0% 2.3% 2.1% 1 Among patients with measured EF 2 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG On-pump procedures -- 30
  25. 25. Isolated CABG Procedures Subset: On-pump procedures Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Complications Summary & Risk-Adjustment1 Major Complications or Op. Mortality Observed Rate ................................... - 23.8% 13.8% 13.3% 12.3% Risk-adjusted Rate ............................. - 14.5% 8.9% 10.3% 9.7% Any Reoperation Observed Rate ................................... - 0.0% 4.6% 3.7% 3.8% Risk-adjusted Rate ............................. - 0.0% 3.5% 3.2% 3.2% Deep Sternal Infection/Mediastinitis Observed Rate ................................... - 0.0% 0.0% 0.3% 0.3% Risk-adjusted Rate ............................. - 0.0% 0.0% 0.3% 0.3% Permanent Stroke Observed Rate ................................... - 0.0% 0.0% 1.4% 1.4% Risk-adjusted Rate ............................. - 0.0% 0.0% 1.1% 1.1% Renal Failure2 Observed Rate ................................... - 0.0% 1.6% 2.5% 2.2% Risk-adjusted Rate ............................. - 0.0% 1.1% 2.0% 1.7% Prolonged Ventilation Observed Rate ................................... - 19.0% 10.8% 8.6% 7.8% Risk-adjusted Rate ............................. - 9.7% 5.7% 6.0% 5.6% Readmission3 Readmitted within 30 days4 ................... - 5.0% 18.5% 10.7% 10.1% Length of Stay Summary Total length of stay (days) Mean .................................................. - 9.6 9.3 9.4 9.4 Median ............................................... - 7.0 8.0 8.0 8.0 Post-procedure Length of Stay (days) Mean .................................................. - 8.0 7.2 7.0 7.0 1 Refer to the Report Overview for information on risk-adjustment methodology Median ............................................... - 7.0 6.0 6.0 6.0 Risk-adjustment is not performed on time periods of less than 6 months 2 Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from discharge for v2.81 CABG On-pump procedures -- 31
  26. 26. CABG On-pump procedures -- 32
  27. 27. Isolated CABG Procedures Subset: Off-pump procedures Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of Off-Pump Procedures - 11 51 7,232 14,582 Demographics Age (years), median .............................. - 78.0 71.0 66.0 66.0 Gender, Female ..................................... - 9.1% 29.4% 26.8% 27.1% Race, Non-caucasian ............................ - 9.1% 2.0% 15.7% 18.2% Multiple Races ....................................... - 0.0% 2.0% 1.3% 1.0% Obesity (BMI 30.0+) .............................. - 54.5% 37.3% 43.5% 43.2% Comorbidities Diabetes Mellitus ................................... - 45.5% 60.8% 49.1% 49.0% Insulin-Dependent .............................. - 27.3% 45.1% 18.5% 18.6% Hypertension ......................................... - 54.5% 94.1% 90.7% 90.2% Dyslipidemia .......................................... - 54.5% 74.5% 91.1% 91.1% Current/Recent Cigarette Smoker ......... - 18.2% 19.6% 21.4% 21.4% Chronic Lung Disease, Mild+ ................. - 18.2% 35.3% 21.0% 20.0% Congestive Heart Failure ....................... - 0.0% 41.2% 16.7% 17.4% CHF / NYHA class IV1 ........................ - 0.0% 2.0% 3.5% 3.5% Peripheral Arterial Disease .................... - 9.1% 23.5% 15.3% 16.1% Cerebrovascular Disease ...................... - 27.3% 27.5% 22.8% 23.0% CVA .................................................... - 0.0% 7.8% 9.1% 9.1% Renal failure, Dialysis-Dependent ......... - 0.0% 3.9% 3.7% 3.6% Last Creatinine Preop >= 4.0 mg/dl ....... - 0.0% 2.0% 3.1% 3.1% Immunosuppressive Treatment ............. - 0.0% 0.0% 3.9% 3.7% Previous Interventions Previous Cardiac Surgery2 .................... - 0.0% 3.9% 2.6% 2.7% Previous CAB ..................................... - 0.0% 2.0% 1.7% 1.7% Previous PCI ......................................... - 27.3% 31.4% 32.6% 33.0% Status Surgery status, Emergent or Salvage .... - 9.1% 2.0% 4.1% 3.6% MI .......................................................... - 18.2% 43.1% 53.2% 51.9% <= 7 days Prior to Surgery ................. - 18.2% 23.5% 29.5% 27.0% Cardiogenic Shock ................................ - 9.1% 0.0% 1.0% 1.0% Resuscitation ......................................... - 0.0% 0.0% 0.1% 0.1% 1 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class 2 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG Off-pump procedures -- 33
  28. 28. Isolated CABG Procedures Subset: Off-pump procedures Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Hemodynamics and Catheterization Triple Vessel Disease ............................ - 63.6% 68.6% 65.0% 63.9% Left Main Disease (>=50% stenosis) ..... - 54.5% 29.4% 30.3% 28.9% Ejection Fraction < 40%1 ....................... - 0.0% 27.7% 14.9% 14.3% Aortic Stenosis ...................................... - 0.0% 5.9% 4.0% 4.1% Mitral Insufficiency, Mild+ ...................... - 9.1% 43.1% 31.8% 31.1% Operative Information IABP, Preoperative ................................ - 0.0% 9.8% 6.1% 5.6% Cross-Clamp Time (min) Mean .................................................. -- -- -- -- -- Median ............................................... -- -- -- -- -- Cardiopulmonary Bypass Time (min) Mean .................................................. -- -- -- -- -- Median ............................................... -- -- -- -- -- Postoperative Information Ventilation hours, total Mean .................................................. - 12.4 6.3 12.7 13.2 Median ............................................... - 8.1 3.7 4.7 4.9 ICU hours, total Mean .................................................. - 117.9 133.0 71.6 65.1 Median ............................................... - 120.5 122.4 49.4 46.0 Mortality Summary & Risk-Adjustment2 In-hospital Mortality Observed rate ..................................... - 0.0% 2.0% 1.6% 1.5% Risk-adjusted rate .............................. - 0.0% 1.7% 1.6% 1.5% Operative Mortality Observed rate ..................................... - 0.0% 3.9% 2.3% 2.1% Risk-adjusted rate .............................. - 0.0% 3.3% 2.2% 2.1% 1 Among patients with measured EF 2 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG Off-pump procedures -- 34
  29. 29. Isolated CABG Procedures Subset: Off-pump procedures Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Complications Summary & Risk-Adjustment1 Major Complications or Op. Mortality Observed Rate ................................... - 18.2% 11.8% 9.9% 9.4% Risk-adjusted Rate ............................. - 17.7% 9.7% 10.1% 9.8% Any Reoperation Observed Rate ................................... - 0.0% 0.0% 2.9% 3.1% Risk-adjusted Rate ............................. - 0.0% 0.0% 2.9% 3.2% Deep Sternal Infection/Mediastinitis Observed Rate ................................... - 0.0% 0.0% 0.2% 0.3% Risk-adjusted Rate ............................. - 0.0% 0.0% 0.2% 0.3% Permanent Stroke Observed Rate ................................... - 0.0% 0.0% 1.0% 1.0% Risk-adjusted Rate ............................. - 0.0% 0.0% 1.0% 1.1% Renal Failure2 Observed Rate ................................... - 0.0% 0.0% 2.0% 1.7% Risk-adjusted Rate ............................. - 0.0% 0.0% 2.0% 1.8% Prolonged Ventilation Observed Rate ................................... - 18.2% 9.8% 5.9% 5.4% Risk-adjusted Rate ............................. - 20.1% 8.1% 6.1% 5.7% Readmission3 Readmitted within 30 days4 ................... - 36.4% 12.0% 10.5% 10.0% Length of Stay Summary Total length of stay (days) Mean .................................................. - 7.4 9.1 8.8 8.6 Median ............................................... - 7.0 9.0 7.0 7.0 Post-procedure Length of Stay (days) Mean .................................................. - 5.5 6.4 6.4 6.3 1 Refer to the Report Overview for information on risk-adjustment methodology Median ............................................... - 5.0 6.0 5.0 5.0 Risk-adjustment is not performed on time periods of less than 6 months 2 Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from discharge for v2.81 CABG Off-pump procedures -- 35
  30. 30. CABG Off-pump procedures -- 36
  31. 31. Isolated CABG Procedures Subset: First Operations Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of First Operations - 32 108 53,693 113,315 Demographics Age (years), median .............................. - 72.5 70.0 66.0 66.0 Gender, Female ..................................... - 9.4% 26.9% 24.5% 24.5% Race, Non-caucasian ............................ - 6.3% 2.8% 16.8% 17.4% Multiple Races ....................................... - 0.0% 2.8% 1.2% 1.0% Obesity (BMI 30.0+) .............................. - 43.8% 44.4% 44.9% 44.6% Comorbidities Diabetes Mellitus ................................... - 46.9% 50.9% 49.3% 49.3% Insulin-Dependent .............................. - 25.0% 33.3% 18.0% 18.2% Hypertension ......................................... - 71.9% 88.9% 89.3% 89.2% Dyslipidemia .......................................... - 71.9% 79.6% 89.5% 90.0% Current/Recent Cigarette Smoker ......... - 9.4% 23.1% 22.7% 22.1% Chronic Lung Disease, Mild+ ................. - 6.3% 29.6% 19.3% 17.9% Congestive Heart Failure ....................... - 3.1% 37.0% 17.7% 18.4% CHF / NYHA class IV1 ........................ - 0.0% 0.9% 4.2% 4.1% Peripheral Arterial Disease .................... - 3.1% 15.7% 13.6% 13.7% Cerebrovascular Disease ...................... - 15.6% 25.0% 21.5% 21.4% CVA .................................................... - 0.0% 5.6% 7.6% 7.8% Renal failure, Dialysis-Dependent ......... - 0.0% 3.7% 3.2% 3.2% Last Creatinine Preop >= 4.0 mg/dl ....... - 0.0% 1.9% 2.4% 2.5% Immunosuppressive Treatment ............. - 3.1% 0.0% 3.1% 3.3% Previous Interventions Previous Cardiac Surgery2 .................... - 0.0% 0.0% 0.0% 0.0% Previous CAB ..................................... - 0.0% 0.0% 0.0% 0.0% Previous PCI ......................................... - 15.6% 26.9% 30.1% 30.1% Status Surgery status, Emergent or Salvage .... - 21.9% 2.8% 4.6% 4.1% MI .......................................................... - 25.0% 40.7% 54.3% 53.8% <= 7 days Prior to Surgery ................. - 21.9% 22.2% 31.6% 30.1% Cardiogenic Shock ................................ - 15.6% 0.9% 1.5% 1.5% Resuscitation ......................................... - 0.0% 0.0% 0.3% 0.3% 1 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class 2 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG First Operations -- 37
  32. 32. Isolated CABG Procedures Subset: First Operations Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Hemodynamics and Catheterization Triple Vessel Disease ............................ - 62.5% 74.1% 76.4% 76.2% Left Main Disease (>=50% stenosis) ..... - 43.8% 31.5% 31.9% 31.3% Ejection Fraction < 40%1 ....................... - 8.0% 26.3% 15.4% 15.3% Aortic Stenosis ...................................... - 0.0% 5.6% 3.5% 3.5% Mitral Insufficiency, Mild+ ...................... - 6.3% 38.0% 32.6% 32.4% Operative Information IABP, Preoperative ................................ - 18.8% 14.8% 7.4% 6.7% Cross-Clamp Time (min) Mean .................................................. - 75.6 - 71.0 69.1 Median ............................................... - 77.0 - 66.0 65.0 Cardiopulmonary Bypass Time (min) Mean .................................................. - 110.8 51.5 96.9 94.3 Median ............................................... - 111.0 48.0 91.0 89.0 Postoperative Information Ventilation hours, total Mean .................................................. - 28.2 9.1 16.8 16.5 Median ............................................... - 8.7 5.3 5.7 5.6 ICU hours, total Mean .................................................. - 134.8 142.6 77.6 71.9 Median ............................................... - 120.3 121.2 51.6 48.0 Mortality Summary & Risk-Adjustment2 In-hospital Mortality Observed rate ..................................... - 3.1% 0.9% 1.8% 1.7% Risk-adjusted rate .............................. - 2.6% 0.7% 1.8% 1.6% Operative Mortality Observed rate ..................................... - 3.1% 1.9% 2.5% 2.2% Risk-adjusted rate .............................. - 2.6% 1.5% 2.4% 2.2% 1 Among patients with measured EF 2 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG First Operations -- 38
  33. 33. Isolated CABG Procedures Subset: First Operations Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Complications Summary & Risk-Adjustment1 Major Complications or Op. Mortality Observed Rate ................................... - 21.9% 13.9% 12.7% 11.8% Risk-adjusted Rate ............................. - 18.0% 11.3% 12.4% 11.7% Any Reoperation Observed Rate ................................... - 0.0% 2.8% 3.5% 3.6% Risk-adjusted Rate ............................. - 0.0% 2.5% 3.5% 3.6% Deep Sternal Infection/Mediastinitis Observed Rate ................................... - 0.0% 0.0% 0.3% 0.3% Risk-adjusted Rate ............................. - 0.0% 0.0% 0.3% 0.3% Permanent Stroke Observed Rate ................................... - 0.0% 0.0% 1.4% 1.4% Risk-adjusted Rate ............................. - 0.0% 0.0% 1.4% 1.3% Renal Failure2 Observed Rate ................................... - 0.0% 1.0% 2.4% 2.1% Risk-adjusted Rate ............................. - 0.0% 1.0% 2.3% 2.1% Prolonged Ventilation Observed Rate ................................... - 18.8% 11.1% 8.1% 7.3% Risk-adjusted Rate ............................. - 14.9% 8.6% 7.9% 7.3% Readmission3 Readmitted within 30 days4 ................... - 16.1% 15.0% 10.6% 10.0% Length of Stay Summary Total length of stay (days) Mean .................................................. - 8.8 9.2 9.3 9.3 Median ............................................... - 7.0 8.0 8.0 8.0 Post-procedure Length of Stay (days) Mean .................................................. - 7.1 6.9 6.9 6.9 1 Refer to the Report Overview for information on risk-adjustment methodology Median ............................................... - 6.0 6.0 6.0 6.0 Risk-adjustment is not performed on time periods of less than 6 months 2 Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from discharge for v2.81 CABG First Operations -- 39
  34. 34. CABG First Operations -- 40
  35. 35. Isolated CABG Procedures Subset: Reoperations Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of Reoperations - - 8 1,186 2,844 Demographics Age (years), median .............................. - - 74.0 69.0 69.0 Gender, Female ..................................... - - 12.5% 23.6% 22.0% Race, Non-caucasian ............................ - - 0.0% 12.2% 13.7% Multiple Races ....................................... - - 0.0% 0.9% 0.7% Obesity (BMI 30.0+) .............................. - - 37.5% 43.8% 44.4% Comorbidities Diabetes Mellitus ................................... - - 62.5% 51.4% 49.8% Insulin-Dependent .............................. - - 50.0% 18.0% 19.8% Hypertension ......................................... - - 75.0% 94.8% 95.1% Dyslipidemia .......................................... - - 75.0% 95.3% 96.3% Current/Recent Cigarette Smoker ......... - - 0.0% 16.4% 16.6% Chronic Lung Disease, Mild+ ................. - - 50.0% 24.7% 22.8% Congestive Heart Failure ....................... - - 25.0% 18.0% 19.2% CHF / NYHA class IV1 ........................ - - 0.0% 3.3% 3.8% Peripheral Arterial Disease .................... - - 12.5% 24.5% 24.2% Cerebrovascular Disease ...................... - - 50.0% 28.7% 29.3% CVA .................................................... - - 25.0% 8.4% 9.7% Renal failure, Dialysis-Dependent ......... - - 0.0% 2.9% 2.9% Last Creatinine Preop >= 4.0 mg/dl ....... - - 0.0% 2.0% 2.4% Immunosuppressive Treatment ............. - - 0.0% 3.9% 3.7% Previous Interventions Previous Cardiac Surgery2 .................... - - 100.0% 100.0% 100.0% Previous CAB ..................................... - - 75.0% 72.3% 73.9% Previous PCI ......................................... - - 87.5% 59.0% 59.6% Status Surgery status, Emergent or Salvage .... - - 12.5% 3.8% 3.0% MI .......................................................... - - 62.5% 60.8% 61.0% <= 7 days Prior to Surgery ................. - - 37.5% 19.6% 19.3% Cardiogenic Shock ................................ - - 0.0% 2.1% 1.8% Resuscitation ......................................... - - 0.0% 0.6% 0.4% 1 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class 2 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG Reoperations -- 41
  36. 36. Isolated CABG Procedures Subset: Reoperations Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Hemodynamics and Catheterization Triple Vessel Disease ............................ - - 75.0% 78.4% 79.5% Left Main Disease (>=50% stenosis) ..... - - 50.0% 42.5% 40.1% Ejection Fraction < 40%1 ....................... - - 25.0% 17.4% 16.4% Aortic Stenosis ...................................... - - 0.0% 5.6% 5.5% Mitral Insufficiency, Mild+ ...................... - - 37.5% 38.6% 39.3% Operative Information IABP, Preoperative ................................ - - 25.0% 6.0% 5.7% Cross-Clamp Time (min) Mean .................................................. - - - 75.5 73.2 Median ............................................... - - - 68.0 68.0 Cardiopulmonary Bypass Time (min) Mean .................................................. - - 70.5 115.7 112.4 Median ............................................... - - 68.0 108.0 104.0 Postoperative Information Ventilation hours, total Mean .................................................. - - 7.7 28.4 28.6 Median ............................................... - - 6.9 6.9 6.6 ICU hours, total Mean .................................................. - - 138.1 92.0 87.0 Median ............................................... - - 140.8 63.0 52.0 Mortality Summary & Risk-Adjustment2 In-hospital Mortality Observed rate ..................................... - - 0.0% 5.5% 4.7% Risk-adjusted rate .............................. - - 0.0% 6.9% 6.1% Operative Mortality Observed rate ..................................... - - 0.0% 6.7% 5.8% Risk-adjusted rate .............................. - - 0.0% 7.7% 6.8% 1 Among patients with measured EF 2 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG Reoperations -- 42
  37. 37. Isolated CABG Procedures Subset: Reoperations Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Complications Summary & Risk-Adjustment1 Major Complications or Op. Mortality Observed Rate ................................... - - 0.0% 19.9% 19.8% Risk-adjusted Rate ............................. - - 0.0% 23.1% 22.9% Any Reoperation Observed Rate ................................... - - 0.0% 6.2% 6.9% Risk-adjusted Rate ............................. - - 0.0% 8.0% 8.9% Deep Sternal Infection/Mediastinitis Observed Rate ................................... - - 0.0% 0.5% 0.4% Risk-adjusted Rate ............................. - - 0.0% 0.5% 0.4% Permanent Stroke Observed Rate ................................... - - 0.0% 1.9% 2.1% Risk-adjusted Rate ............................. - - 0.0% 2.6% 2.8% Renal Failure2 Observed Rate ................................... - - 0.0% 4.9% 4.0% Risk-adjusted Rate ............................. - - 0.0% 5.7% 4.5% Prolonged Ventilation Observed Rate ................................... - - 0.0% 12.7% 13.4% Risk-adjusted Rate ............................. - - 0.0% 15.4% 16.2% Readmission3 Readmitted within 30 days4 ................... - - 25.0% 13.4% 12.0% Length of Stay Summary Total length of stay (days) Mean .................................................. - - 9.5 10.5 10.5 Median ............................................... - - 9.5 9.0 9.0 Post-procedure Length of Stay (days) Mean .................................................. - - 6.0 7.7 7.7 1 Refer to the Report Overview for information on risk-adjustment methodology Median ............................................... - - 5.5 6.0 6.0 Risk-adjustment is not performed on time periods of less than 6 months 2 Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from discharge for v2.81 CABG Reoperations -- 43
  38. 38. CABG Reoperations -- 44
  39. 39. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Number of Cases - 1 17 3,665 18,759 Demographics Age (years) Mean ..................................................... - 75.0 70.2 65.9 65.5 Median ................................................... - 75.0 75.0 68.0 67.0 25th Percentile ....................................... - 75.0 64.0 60.0 59.0 75th Percentile ....................................... - 75.0 79.0 74.0 74.0 Age >= 65 years old .............................. - 100.0% 70.6% 60.0% 59.7% Gender, Female ........................................ - 0.0% 29.4% 39.8% 36.9% Missing .................................................. - 0.0% 0.0% 0.1% 0.0% Race1 Caucasian ............................................. - 100.0% 100.0% 85.9% 86.9% Black ...................................................... - 0.0% 0.0% 6.1% 5.6% Asian ..................................................... - 0.0% 0.0% 1.4% 1.5% Native American .................................... - 0.0% 0.0% 0.6% 0.5% Native Hawaiian/Pacific Islander ........... - 0.0% 0.0% 0.4% 0.2% Other ..................................................... - 0.0% 0.0% 3.7% 3.0% Multiple Races ....................................... - 0.0% 0.0% 1.1% 0.6% Missing / Not Documented .................... - 0.0% 0.0% 2.9% 3.0% Pt. Declined to Disclose2 ....................... - 0.0% 0.0% 0.4% 0.6% Hispanic or Latino Ethnicity ...................... - 0.0% 41.2% 11.1% 7.2% Missing/ Not Documented ..................... - 0.0% 5.9% 4.0% 3.9% Body Mass Index3 Underweight (BMI < 18.5) ...................... - 0.0% 0.0% 0.9% 0.9% Normal (BMI 18.5 - 24.9) ....................... - 0.0% 23.5% 18.9% 19.0% Overweight (BMI 25.0 - 29.9) ................ - 100.0% 35.3% 31.4% 32.9% Obese I (BMI 30.0 - 34.9) ...................... - 0.0% 23.5% 26.2% 25.8% Obese II (BMI 35.0 - 39.9) ..................... - 0.0% 11.8% 13.2% 12.9% Morbid Obesity (BMI 40.0+) ................... - 0.0% 5.9% 9.2% 8.3% Missing Height ....................................... - 0.0% 0.0% 0.1% 0.2% 1 Data presented in the report represent the individual response rates for each race category Missing Weight ...................................... - 0.0% 0.0% 0.0% 0.2% shown; summing the individual non-caucasian categories will not result in the same rates as shown in the graph since non-caucasian, as defined for the graph, does not include races or ethnicities reported in combination with caucasian 2 Option added in v2.81 3 BMI = Weight(kg) / Height(m)2 AV Replace -- 45
  40. 40. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Comorbidities Diabetes Mellitus ...................................... - 0.0% 23.5% 34.2% 30.4% Diet Control ........................................ - 0.0% 0.0% 2.2% 2.7% Oral Control ........................................ - 0.0% 17.6% 18.3% 16.2% Insulin Control .................................... - 0.0% 5.9% 9.7% 7.9% Other SQ Medication Control1 ............ - 0.0% 0.0% 0.3% 0.3% Other Control ...................................... - 0.0% 0.0% 0.2% 0.1% Missing Control ................................... - - 0.0% 1.0% 0.8% Missing .................................................. - 0.0% 0.0% 0.3% 0.4% Hypertension ............................................ - 0.0% 70.6% 81.0% 78.8% Missing .................................................. - 0.0% 5.9% 0.3% 0.3% Current/Recent Cigarette Smoker ............ - 0.0% 23.5% 16.1% 13.3% Smoker, Current Status Unknown1 ........ - 0.0% 5.9% 0.4% 0.4% Missing .................................................. - 0.0% 0.0% 0.8% 0.7% Chronic Lung Disease Mild ........................................................ - 0.0% 17.6% 10.2% 9.4% Moderate ............................................... - 0.0% 17.6% 4.6% 3.9% Severe ................................................... - 0.0% 0.0% 4.6% 3.4% Unknown Severity1 ................................ - 0.0% 29.4% 6.2% 5.6% Missing .................................................. - 0.0% 23.5% 3.1% 1.8% Congestive Heart Failure .......................... - 0.0% 64.7% 28.2% 33.8% CHF / NYHA Class I2 .......................... - 0.0% 23.5% 1.9% 3.1% CHF / NYHA Class II .......................... - 0.0% 5.9% 9.4% 13.6% CHF / NYHA Class III ......................... - 0.0% 17.6% 14.1% 17.0% CHF / NYHA Class IV ......................... - 0.0% 11.8% 5.8% 5.0% CHF / Missing Class ........................... - - 0.0% 2.2% 2.0% Missing .................................................. - 0.0% 17.6% 1.5% 1.2% Peripheral Arterial Disease ....................... - 0.0% 11.8% 7.9% 7.6% Missing .................................................. - 0.0% 0.0% 1.2% 0.5% Cerebrovascular Disease ......................... - 0.0% 23.5% 15.0% 15.2% 1 Option added in v2.81 Missing .................................................. - 0.0% 0.0% 1.2% 0.9% 2 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class Coma/Nonresponsive State ................... - 0.0% 0.0% 0.3% 0.3% Missing ............................................... - 0.0% 0.0% 0.9% 1.4% AV Replace -- 46
  41. 41. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 CVD TIA ................................................ - 0.0% 0.0% 3.9% 4.0% Missing ............................................... - 0.0% 11.8% 1.6% 1.1% Carotid Stenosis1 None ................................................... - 100.0% 82.4% 92.6% 93.0% 50-79%2 .............................................. - 0.0% 11.8% 4.5% 4.6% 80-100% ............................................. - 0.0% 0.0% 0.7% 0.6% Missing/Not Documented ................... - 0.0% 5.9% 2.3% 1.7% CVD Prior Carotid Surgery .................... - 0.0% 11.8% 1.5% 1.5% Missing ............................................... - 0.0% 0.0% 1.3% 0.9% Cerebrovascular Accident ..................... - 0.0% 5.9% 6.7% 6.9% Missing ............................................... - 0.0% 5.9% 1.3% 0.9% Renal Failure, Dialysis-Dependent ........... - 0.0% 0.0% 3.1% 2.1% Missing .................................................. - 0.0% 5.9% 0.4% 0.4% Last Creatinine Preop Mean ..................................................... - 1.0 1.0 1.1 1.1 Median ................................................... - 1.0 1.0 1.0 0.9 25th Percentile ....................................... - 1.0 0.9 0.8 0.8 75th Percentile ....................................... - 1.0 1.2 1.2 1.1 Missing .................................................. - 0.0% 0.0% 0.3% 0.4% Value >= 4.0 mg/dL ............................... - 0.0% 0.0% 1.9% 1.5% Immunosuppressive Treatment ................ - 0.0% 5.9% 3.6% 4.1% Missing .................................................. - 0.0% 0.0% 1.2% 0.8% Infectious Endocarditis .............................. - 0.0% 0.0% 6.8% 7.3% Missing .................................................. - 0.0% 0.0% 0.1% 0.3% Previous Interventions Previous Cardiac Surgery3 ....................... - 0.0% 17.6% 7.3% 10.7% First reoperation .................................... - 0.0% 17.6% 6.9% 9.8% 1 Defined as highest level of occlusion in either carotid. Previous CABG ........................................ - 0.0% 11.8% 2.2% 2.8% 2 Option added in v2.81 3 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery Previous Valve .......................................... - 0.0% 5.9% 5.2% 7.8% Previous AICD .......................................... - 0.0% 5.9% 1.1% 1.0% AV Replace -- 47
  42. 42. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Previous Pacemaker ................................. - 0.0% 0.0% 2.6% 2.8% Status Surgery Status Elective .................................................. - 0.0% 58.8% 77.9% 80.7% Urgent .................................................... - 100.0% 41.2% 21.4% 18.4% Emergent ............................................... - 0.0% 0.0% 0.6% 0.7% Emergent Salvage ................................. - 0.0% 0.0% 0.1% 0.1% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% MI .............................................................. - 0.0% 0.0% 10.3% 9.6% Missing .................................................. - 0.0% 23.5% 0.8% 0.6% Cardiogenic Shock At the time of surgery ............................ - 0.0% 5.9% 0.5% 0.7% Within 24 hrs of surgery1 ....................... - 0.0% 0.0% 0.2% 0.2% Missing .................................................. - 0.0% 0.0% 0.2% 0.3% Hemodynamics and Catheterization Ejection Fraction Mean ..................................................... - 60.0 54.8 57.2 57.7 Median ................................................... - 60.0 55.0 60.0 60.0 25th Percentile ....................................... - 60.0 50.0 55.0 55.0 75th Percentile ....................................... - 60.0 65.0 63.0 65.0 EF missing or not measured .................. - 0.0% 11.8% 4.3% 2.8% EF <40%2 .............................................. - 0.0% 13.3% 7.6% 7.1% Pulmonary Hypertension3 ......................... - - 70.0% 48.7% 45.5% PA mean/systolic pressure missing or not measured .................................... - 100.0% 41.2% 47.9% 46.5% Aortic Stenosis .......................................... - 100.0% 94.1% 84.2% 82.7% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Aortic Insufficiency 1 Option added in v2.81 Trivial ..................................................... - 0.0% 0.0% 11.2% 14.4% 2 Among patients with measured EF Mild ........................................................ - 0.0% 5.9% 22.8% 24.1% 3 PA systolic pressure > 35mmHg Moderate ............................................... - 0.0% 0.0% 14.1% 15.2% Severe ................................................... - 100.0% 94.1% 24.6% 21.9% Missing/Not Documented ...................... - 0.0% 0.0% 6.7% 4.9% AV Replace -- 48
  43. 43. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Preoperative Medications Aspirin ....................................................... - 0.0% 47.1% 54.4% 49.2% Among Eligible Cases ........................... - 0.0% 47.1% 54.9% 49.7% Contraindicated / Not Indicated ............. - 0.0% 0.0% 1.0% 1.1% Missing .................................................. - 0.0% 5.9% 1.1% 0.8% Inotropics .................................................. - 0.0% 5.9% 1.0% 1.1% Missing .................................................. - 0.0% 0.0% 0.3% 0.2% Beta Blockers ........................................... - 0.0% 23.5% 64.2% 60.2% Among Eligible Cases ........................... - 0.0% 25.0% 68.1% 64.3% Contraindicated / Not Indicated ............. - 0.0% 5.9% 5.6% 6.2% Missing .................................................. - 0.0% 0.0% 0.0% 0.2% Steroids .................................................... - 0.0% 5.9% 2.4% 2.1% Among Eligible Cases ........................... - 0.0% 5.9% 2.4% 2.1% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.0% 0.0% Missing .................................................. - 0.0% 0.0% 0.5% 0.4% Nitrates IV ................................................. - 0.0% 5.9% 0.6% 0.4% Missing .................................................. - 0.0% 0.0% 0.5% 0.4% ACE Inhibitors ........................................... - 0.0% 5.9% 36.5% 33.5% Among Eligible Cases ........................... - 0.0% 6.3% 37.2% 34.0% Contraindicated / Not Indicated ............. - 0.0% 5.9% 1.8% 1.3% Missing .................................................. - 0.0% 0.0% 1.3% 0.9% Anticoagulants .......................................... - 0.0% 29.4% 13.0% 11.4% Missing .................................................. - 0.0% 0.0% 0.5% 0.4% Coumadin1 ................................................ - 0.0% 0.0% 0.7% 0.4% Missing .................................................. - 0.0% 0.0% 0.7% 0.5% Coumadin w/in 5 Days 2 ........................... - - 0.0% 0.9% 0.8% Among Eligible Cases ........................... - - 0.0% 0.9% 0.8% Contraindicated / Not Indicated ............. - - 0.0% 0.2% 0.2% 1 Variable dropped in v2.9 Missing .................................................. - - 0.0% 0.6% 0.5% 2 Variable added in v2.9 AV Replace -- 49
  44. 44. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Lipid-Lowering agents ............................... - 0.0% 23.5% 55.4% 53.6% Among Eligible Cases ........................... - 0.0% 23.5% 56.0% 54.1% Contraindicated / Not Indicated ............. - 0.0% 0.0% 1.1% 0.9% Missing .................................................. - 0.0% 0.0% 1.1% 0.8% Glycoprotein IIb/IIIa Inhibitor ..................... - 0.0% 0.0% 0.1% 0.1% Missing .................................................. - 0.0% 0.0% 0.4% 0.3% ADP Inhibitors within 5 Days .................... - 0.0% 0.0% 1.4% 1.5% Among Eligible Cases ........................... - 0.0% 0.0% 1.4% 1.5% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.1% 0.2% Missing .................................................. - 0.0% 0.0% 0.4% 0.4% ADP Inhibitor Discontinuation1 < 1 Day ............................................... - - - 11.8% 21.2% 1 Day .................................................. - - - 19.6% 19.4% 2 Days ................................................ - - - 17.6% 10.1% 3 Days ................................................ - - - 15.7% 10.4% 4 Days ................................................ - - - 11.8% 18.8% 5 Days ................................................ - - - 19.6% 19.4% Missing .................................................. - - - 3.9% 0.7% Antiplatelets within 5 Days2 ...................... - 0.0% 0.0% 1.8% 1.4% Among Eligible Cases ........................... - 0.0% 0.0% 1.8% 1.4% Contraindicated / Not Indicated ............. - 0.0% 0.0% 0.1% 0.2% Missing .................................................. - 0.0% 0.0% 0.6% 0.5% Operative Information Blood Products Used ................................ - 100.0% 70.6% 31.1% 26.3% Number of Blood Product Units Used 1 Red Blood Cell Unit ......................... - 0.0% 5.9% 6.3% 5.9% 2 Red Blood Cell Units ....................... - 0.0% 11.8% 8.7% 6.4% 3 Red Blood Cell Units ....................... - 0.0% 11.8% 3.0% 2.0% 4+ Red Blood Cell Units ..................... - 100.0% 17.6% 2.9% 2.4% 1+ Fresh Frozen Plasma Units ........... - 0.0% 58.8% 11.7% 9.6% 1+ Cryoprecipitate Units ..................... - 100.0% 47.1% 4.8% 4.9% 1 Excludes patients not on ADP Inhibitors within 5 Days 1+ Platelet Units ................................. - 100.0% 52.9% 17.4% 15.3% 2 Variable dropped in v2.9 Missing .................................................. - 0.0% 0.0% 0.5% 0.6% AV Replace -- 50
  45. 45. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 IABP ......................................................... - 0.0% 29.4% 1.9% 1.7% Preop .................................................. - 0.0% 23.5% 0.3% 0.2% Intraop ................................................ - 0.0% 5.9% 1.3% 1.2% Postop ................................................ - 0.0% 0.0% 0.3% 0.2% Missing timing ..................................... - - 0.0% 0.0% 0.3% Missing .................................................. - 0.0% 0.0% 0.1% 0.1% Robotic Technology Assisted ................... - 0.0% 5.9% 0.1% 0.0% Missing .................................................. - 0.0% 0.0% 0.1% 0.9% Cross-Clamp Time (min) Mean ..................................................... - 89.0 75.0 80.8 74.8 Median ................................................... - 89.0 69.0 75.0 70.0 25th Percentile ....................................... - 89.0 65.0 61.0 55.0 75th Percentile ....................................... - 89.0 80.0 95.0 88.0 Cardiopulmonary Bypass Time (min) Mean ..................................................... - 114.0 117.4 108.8 100.8 Median ................................................... - 114.0 98.0 101.0 93.0 25th Percentile ....................................... - 114.0 89.0 81.0 74.0 75th Percentile ....................................... - 114.0 124.0 126.0 118.0 Circulatory Arrest ...................................... - 0.0% 0.0% 0.8% 0.4% Missing .................................................. - 0.0% 0.0% 0.2% 0.3% Circulatory Arrest Time (min) Mean ..................................................... - - - 17.8 18.0 Median ................................................... - - - 7.0 9.0 25th Percentile ....................................... - - - 3.0 1.0 75th Percentile ....................................... - - - 30.0 20.0 Skin Incision Duration (min) Mean ..................................................... - 234.0 259.4 216.5 204.2 Median ................................................... - 234.0 221.0 204.0 191.0 25th Percentile ....................................... - 234.0 200.0 170.0 157.0 75th Percentile ....................................... - 234.0 302.0 247.0 236.0 AV Replace -- 51
  46. 46. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 OR Duration (min) Mean ..................................................... - 331.0 350.2 300.5 290.1 Median ................................................... - 331.0 318.0 289.0 277.0 25th Percentile ....................................... - 331.0 290.0 246.0 234.0 75th Percentile ....................................... - 331.0 382.0 340.0 330.0 Valve Surgery Aortic Annular Enlargement ...................... - 0.0% 5.9% 4.0% 4.4% Missing .................................................. - 0.0% 0.0% 0.4% 0.9% Valve Replacement Type Mechanical ............................................ - 0.0% 5.9% 11.8% 11.3% Bioprosthetic .......................................... - 100.0% 94.1% 87.9% 88.3% Homograft .............................................. - 0.0% 0.0% 0.0% 0.1% Autograft ................................................ - - - - - Missing .................................................. - 0.0% 0.0% 0.2% 0.4% Antibiotic Selection1, 2 ............................... - 100.0% 100.0% 99.2% 99.4% Exclusions ............................................. - 0.0% 0.0% 1.8% 1.6% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% Antibiotic Timing1, 3 ................................... - 100.0% 100.0% 99.1% 99.0% Exclusions ............................................. - 0.0% 0.0% 1.2% 1.1% Missing .................................................. - 0.0% 0.0% 0.0% 0.1% Antibiotics Discontinued1, 4 ........................ - 100.0% 100.0% 99.1% 99.2% Exclusions ............................................. - 0.0% 0.0% 3.0% 2.8% Missing .................................................. - 0.0% 0.0% 0.1% 0.2% Postoperative Information Blood Products Used ................................ - 100.0% 52.9% 33.1% 27.7% Number of Blood Product Units Used 1 Red Blood Cell Unit ......................... - 0.0% 11.8% 9.2% 8.7% 2 Red Blood Cell Units ....................... - 0.0% 23.5% 10.0% 7.6% 3 Red Blood Cell Units ....................... - 0.0% 0.0% 3.0% 2.8% 4+ Red Blood Cell Units ..................... - 100.0% 17.6% 6.6% 5.1% 1 All antibiotic measures are calculated among patients without exclusions 1+ Fresh Frozen Plasma Units ........... - 0.0% 11.8% 10.3% 8.2% 2 First or second generation cephalosporin prescribed/given prophylactically 1+ Cryoprecipitate Units ..................... - 100.0% 11.8% 5.1% 5.1% 3 Appropriate timing of prophylactic antibiotics 1+ Platelet Units ................................. - 0.0% 29.4% 11.1% 9.4% 4 Prophylactic antibiotics discontinued within 48 hours Missing .................................................. - 0.0% 0.0% 0.1% 0.3% AV Replace -- 52
  47. 47. Isolated Aortic Valve Replacement Procedures Data Summary Participant 30863 STS Period Ending 09/30/2017 2017 is a partial year: Jan 2017 - Sept 2017 Participant 30863 Like Group STS 2015 2016 2017 2017 2017 Intraop/Postop Blood Products Used ........ - 100.0% 82.4% 48.1% 41.3% Total Number of Blood Product Units 1 Red Blood Cell Unit ......................... - 0.0% 11.8% 9.8% 9.6% 2 Red Blood Cell Units ....................... - 0.0% 5.9% 12.7% 10.0% 3 Red Blood Cell Units ....................... - 0.0% 11.8% 5.4% 4.5% 4+ Red Blood Cell Units ..................... - 100.0% 41.2% 12.0% 8.9% 1+ Fresh Frozen Plasma Units ........... - 0.0% 58.8% 19.8% 15.6% 1+ Cryoprecipitate Units ..................... - 100.0% 58.8% 9.6% 9.4% 1+ Platelet Units ................................. - 100.0% 58.8% 24.9% 21.6% Missing .................................................. - 0.0% 0.0% 0.0% 0.0% Ventilation Total Ventilation Hours Mean .................................................. - 19.5 14.1 18.4 15.4 Median ............................................... - 19.5 6.0 5.6 5.3 25th Percentile .................................... - 19.5 4.5 3.7 3.6 75th Percentile .................................... - 19.5 20.5 10.9 9.0 Initial Ventilation Hours Mean .................................................. - 19.5 13.6 12.9 11.3 Median ............................................... - 19.5 5.6 5.5 5.2 Initial Ventilation <6 hours1 ................. - 0.0% 52.9% 55.1% 59.4% Extubated in OR .................................... - 0.0% 17.6% 2.9% 2.8% Missing .................................................. - 0.0% 0.0% 0.1% 0.3% Reintubation .......................................... - 0.0% 11.8% 4.3% 3.2% Missing .................................................. - 0.0% 0.0% 0.2% 0.4% Additional Ventilation Hours2 Mean .................................................. - - 4.0 126.8 129.7 Median ............................................... - - 4.0 65.0 65.0 ICU Stay Total ICU Hours 2 Among patients reintubated Mean .................................................. - 121.9 167.3 84.9 68.0 Median ............................................... - 121.9 137.3 53.9 46.3 25th Percentile .................................... - 121.9 114.4 31.2 25.0 75th Percentile .................................... - 121.9 194.2 98.0 74.8 AV Replace -- 53

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