Original Articles

Analysis of regional congenital cardiac surgical outcomes in Florida using The Society of Thoracic Surgeons Congenital Heart Surgery Database

Jeffrey P. Jacobs^a1 c1, James A. Quintessenza^a1, Redmond P. Burke^a2, Mark S. Bleiweis^a3, Barry J. Byrne^a3, Eric L. Ceithaml^a3, William M. DeCampli^a2, Jorge M. Giroud^a1, Richard A. Perryman^a4, Eliot R. Rosenkranz^a5, Grace Wolff^a5, Vicki Posner^a6, Sue Steverson^a6, William B. Blanchard^a7 and Gerry L. Schiebler^a8

^a1 The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children’s Hospital and Saint Joseph’s Children’s Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), Saint Petersburg and Tampa, Florida, United States of America

^a2 The Congenital Heart Institute of Miami Children’s Hospital and Arnold Palmer Children’s Hospital, Miami and Orlando, Florida, United States of America

^a3 The University of Florida, Gainesville and Jacksonville, Florida, United States of America

^a4 Joe DiMaggio Children’s Hospital, Hollywood, Florida, United States of America

^a5 The University of Miami, Miami, Florida, United States of America

^a6 Florida Children’s Medical Services (CMS), Tallahassee, Florida, United States of America

^a7 Nemours Children’s Clinic and Sacred Heart Children’s Hospital, Pensacola, Florida, United States of America

^a8 Florida Children’s Medical Services, Tallahassee, Florida, United States of America

Abstract

Background Florida is the fourth largest state in the United States of America. In 2004, 218,045 live babies were born in Florida, accounting for approximately 1744 new cases of congenital heart disease. We review the initial experience of The Society of Thoracic Surgeons Congenital Heart Surgery Database with a regional outcomes report, namely the Society of Thoracic Surgeons Florida Regional Report.

Methods Eight centres in Florida provide services for congenital cardiac surgery. The Children’s Medical Services of Florida provide a framework for quality improvement collaboration between centres. All congenital cardiac surgical centres in Florida have voluntarily agreed to submit data to the Society of Thoracic Surgeons Database. The Society of Thoracic Surgeons and Duke Clinical Research Institute prepared a Florida Regional Report to allow detailed regional analysis of outcomes for congenital cardiac surgery.

Results The report of 2007 from the Society of Thoracic Surgeons Congenital Heart Surgery Database includes details of 61,014 operations performed during the 4 year data harvest window, which extended from 2003 through 2006. Of these operations, 6,385 (10.5%) were performed in Florida. Discharge mortality in the data from Florida overall, and from each Florida site, with 95% confidence intervals, is not different from cumulative data from the entire Society of Thoracic Surgeons Database, both for all patients and for patients stratified by complexity.

Conclusions A regional consortium of congenital heart surgery centres in Florida under the framework of the Children’s Medical Services has allowed for inter-institutional collaboration with the goal of quality improvement. This experience demonstrates, first, that the database maintained by the Society of Thoracic Surgeons can provide the framework for regional analysis of outcomes, and second, that voluntary regional collaborative efforts permit the pooling of data for such analysis.

(Accepted March 03 2009)

Keywords

• Paediatric heart surgery;
• surgical outcomes;
• congenital heart disease;
• registry;
• patient safety

Correspondence:

^c1 Correspondence to: Jeffrey P. Jacobs, M.D., FACS, FACC, FCCP, Cardiovascular and Thoracic Surgeon, Surgical Director of Heart Transplantation and ECMO, The Congenital Heart Institute of Florida (CHIF), Division of Thoracic and Cardiovascular Surgery, All Children's Hospital and Saint Joseph's Children's Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida (CSAoF), 625 Sixth Avenue South, Suite 475, Saint Petersburg, Florida 33701, United States of America. Tel: (727) 822-6666; Fax: (727) 821-5994; E-mail: JeffJacobs@msn.com; Web page: http://www.heartsurgery-csa.com/, Web Page: http://www.CHIF.us/