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

摘要: Quality-of-care evaluation must take into account variations in “case mix.” This study reviewed the application of two case-mix complexity-adjustment tools Society Thoracic Surgeons (STS) Congenital Heart Surgery Database: Aristotle Basic Complexity (ABC) score and Risk Adjustment (RACHS-1) method. The 2006 STS Database Report, first report to incorporate both methods, included 45,635 operations from 47 centers. Each operation was assigned an ABC a range 1.5 (lowest complexity) 15 (highest complexity), level 1 4 RACHS-1 category risk) 6 risk). overall discharge mortality 3.9% (1,222/31,719 eligible cardiac index operations). Of operations, 85.8% (27,202/31,719) were for analysis by method, 94.0% (29,813/31,719) approach. With ABC, as complexity increases, also increases. approach allows classification more whereas discriminates better at higher end complexity. stratification is useful method analyzing impact case mix on pediatric surgical outcomes. Both methods facilitate database.