Results
Introduction
With the growth of the internet and increasing consumer awareness, we find that patients facing cardiac operations and their families want specific technical information and that they are reassured by experience and forthright discussion of outcomes. Our 2008 edition of Adult Cardiac Surgery Results brochure focuses on the outcomes of nearly 5000 consecutive patients that we operated on during the nine year period 1998-2006.
Our entire brochure is available on our website and can be viewed by clicking on the Download our brochure link on this page. We hope that you will derive benefit from this information.
Understanding Cardiac Surgery Results
We begin with a simple idea: you have the right to know the results that physicians achieve in their work and the responsibility to understand what those results mean.
In some areas of medicine such results are difficult to measure objectively. However, the outcomes of cardiac operations are easier to measure because of the risk of death and serious complications in the course of treatment. Once these basic results are measured, interpreting and understanding them requires more information and thought.
You can begin to understand these results by knowing the mortality rates for the various operations performed. At first glance you might conclude that the surgeon with the lowest mortality rate was the best surgeon, but that might or might not be correct. You need to know more to make a good judgment. Would you prefer a surgeon with no deaths (0% mortality) in 50 cases to a surgeon with 3 deaths in 300 cases (1% mortality)? What is the value of experience and higher volume? Cardiac surgery is a competitive field, and busier and more experienced surgeons often operate on more difficult cases. How should you factor this into your knowledge of results?
As you consider the results obtained by a single group, you will need a national or state standard as a benchmark for comparison. Every technical intervention carries some risk and you can fairly assess the risk of an operation only if you compare that risk to some standard.
Our 2008 edition of Adult Cardiac Surgery Results summarizes the outcomes of nearly 5000 consecutive patients we operated on during the nine year period 1998-2006. We collect and report our data according to the guidelines established by the Society of Thoracic Surgeons (STS) National Database that contains the outcomes for more than three million operations performed in the United States during the past two decades. When we compare our own results to those obtained nationally, we can determine if we are meeting the quality standards for cardiac surgery in the United States. We present this information to you so that you can compare our results to those that are obtained nationally.
We use the STS data for two kinds of benchmarks. First, we use it to compare our results to the national averages. Second, it provides algorithms that permit us to “risk adjust” our cases to account for the difficulty in our population compared to the national population. Then, we can calculate “expected” outcomes based on the difficulty of our population and compare those to our actual outcomes. A good program strives to produce actual mortality and complication rates lower than those “expected” by the algorithms. In this summary we show direct comparison of our results to the national standards and risk-adjusted results.
Our results are much more than a reflection of our technical efforts. They are the product of a system of care that we evolved over the past 25 years, groomed by aggressive quality assurance and a committed team effort. They also reflect some guiding surgical ideas that we outline in this brochure. If you have any questions or comments, or if you would like to receive additional copies of this brochure, please contact us.