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Post-discharge Outcomes Following Correction Of Congenital Heart Defects (chd)
James St Louis, MD1, Brian Bateson, DO
1, Jeffrey Jacobs
2, Erle Austin, MD
3, Christopher Calderone, MD
4, Tara Karamlou, MD
5, Mark Plunkett, MD
6, David Overman, MD
7, James Kirklin, MD
8.
1Augusta University, Augusta, GA, USA,
2University of Florida, Gainesville, FL, USA,
3University of Louisville, Louisville, KY, USA,
4Baylor College of Medicine, Houston, TX, USA,
5Cleveland Clinic, Cleveland, OH, USA,
6University of Illinois, Peoria, IL, USA,
7Minneapolis Children's Hospital, Minneapolis, MN, USA,
8Kirklin Solutions, Birmingham, AL, USA.
Objectives:The STS-Congenital Heart Surgery Database successfully provides in-patient and 30-day post-discharge evaluation following correction of a CHD. Assessment of long-term outcomes and benchmark standards are lacking on a national scale. We have developed a mechanism to reliably collect follow-up data at a national level for purposes of quality assurance (QA). We report initial data captured. Methods:CHD procedures were collected from US center harvest files (utilized by the STS-CHSD) submitted via a password-protected dashboard to a central data center. Centers are prompted to input post-discharge data for 6 months and one-year follow-up. The collected data include readmission for non-cardiac operative procedures, catheter-based interventional procedures, and mortality. Data are aggregated and individual center analysis with comparisons to the aggregate are provided.Results:Eleven US centers contributed a total of 3,290 follow-up events. Completion of the follow-up at six months and one-year were 85% (n=1532) and 87% (n=1377), respectively. Mortality and readmission rate for a non-cardiac operation of entire cohort at 6 months and one-year were 1% (n=15) and 0.6% (n=8), 5% (n=81) and 5% (n=77), respectively. Table#1 presents data by CHD. Conclusions:For the first time, a mechanism for attaining post-discharge follow-up of outcomes data following correction of CHD has been achieved. Post-discharged mortality and readmission are low for common CHD repairs. Increased center participation will greatly increase the impact of these data for center QA.
Table # 1
| | | | | | | | |
| Primary Procedure | Follow-up completed | Mortality | Readmission noncardiac operation | Catheter-based intervention |
| 6 months | 1 Year | 6 months | 1 year | 6 months | 1 year | 6 months | 1 year |
| CoA repair | 104 | 94 | 0% | 1% | 2% | 2% | 10% | 3% |
| VSD repair | 357 | 310 | 1% | 1% | 4% | 6% | 1% | 1% |
| AVSD repair | 199 | 181 | 1% | 0.5% | 7% | 3% | 2% | 1% |
| TOF repair | 199 | 181 | 0% | 0% | 7% | 3% | 3% | 4% |
| PAPVC repair | 23 | 23 | 0% | 0% | 0% | 0% | 0% | 0% |
| TAPVC repair | 4 | 4 | 0% | 0% | 50% | 50% | 100% | 0% |
| Bidirectional Glenn | 234 | 186 | 2% | 0.5% | 5% | 7% | 12% | 9% |
| Fontan Procedure | 180 | 148 | 0.6% | 0.7% | 5% | 3% | 6% | 6% |
| Arterial Switch Operation | 84 | 75 | 1% | 0% | 5% | 1% | 6% | 1% |
| Truncus Arteriosus repair | 25 | 16 | 0% | 0% | 8% | 0% | 16% | 31% |
| Norwood Procedure | 142 | 111 | 4% | 4% | 5% | 7% | 35% | 16% |
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