Our Summary
This research paper is about a new way to measure the performance of hospitals and surgical groups in the field of adult heart surgery. The Society of Thoracic Surgeons (STS) has traditionally only had ways to measure performance for individual procedures. Now, they’ve developed a method that combines the most common heart procedures into a single score that can be used to evaluate the entire operation.
The study included data from a one-year period and a three-year period. They looked at several different types of heart surgery, including procedures on the coronary artery, aortic valve, and mitral valve, as well as combinations of these procedures.
The new measurement was calculated using a type of statistical model that takes into account both the risk of death and the risk of complications from the surgery. They then assigned a star rating based on how the hospital or surgical group’s score compared to the average STS score.
The results showed that the types of procedures performed most often in North America over the three-year period were coronary artery bypass grafting, aortic valve replacement, and mitral valve repair or replacement. The scores were similar for both the one-year and three-year periods and the distribution of scores was also similar.
The researchers decided to use the three-year time frame for practical use because it was more reliable and better at identifying outliers (those that were significantly better or worse than average). They found that hospitals or surgical groups with one, two, or three stars had different rates of death and complications.
In conclusion, this new method of measuring performance provides a comprehensive and reliable way to assess the quality of adult heart surgery practices. It allows for a better understanding of how well these groups are doing overall, rather than just looking at individual procedures.
FAQs
- What is the new method developed by the Society of Thoracic Surgeons (STS) to measure the performance of hospitals and surgical groups in adult heart surgery?
- How are the scores calculated and what factors are taken into account in the new measurement method?
- Why did the researchers choose to use the three-year time frame for practical use?
Doctor’s Tip
A helpful tip a doctor might tell a patient about cardiac surgery is to make sure to follow all pre-operative instructions provided by the medical team, such as fasting before the surgery and stopping certain medications as directed. It’s important to communicate openly and honestly with your healthcare team about any concerns or questions you may have. After surgery, following post-operative care instructions, attending follow-up appointments, and participating in cardiac rehabilitation can help ensure a successful recovery. Remember, it’s normal to feel anxious or overwhelmed before surgery, but trust in your medical team and know that they are there to support you every step of the way.
Suitable For
Patients who are typically recommended for cardiac surgery include those with severe coronary artery disease, aortic valve disease, mitral valve disease, or a combination of these conditions. These patients may have symptoms such as chest pain, shortness of breath, fatigue, palpitations, or swelling in the legs. They may also have had heart attacks, heart failure, or other heart-related issues that require surgical intervention.
Additionally, patients who have not responded well to other treatments, such as medications or lifestyle changes, may also be recommended for cardiac surgery. Those who are at high risk for complications or death from their heart condition may benefit from surgical intervention to improve their quality of life and reduce their risk of future cardiac events.
Overall, patients who are in need of surgical correction for significant heart disease and who are deemed to be good candidates for surgery based on their overall health and risk factors are typically recommended for cardiac surgery.
Timeline
Before cardiac surgery, a patient typically undergoes a series of tests and evaluations to determine the best course of treatment. This may involve consultations with cardiologists, imaging tests such as echocardiograms or angiograms, and blood tests to assess overall health and potential risks.
Once a decision is made to proceed with surgery, the patient will go through a pre-operative preparation phase which may include medications, lifestyle changes, and further consultations with the surgical team.
During the surgery itself, the patient is under general anesthesia and the surgeon performs the necessary procedures to address the heart condition. This can involve bypassing blocked arteries, repairing or replacing heart valves, or other interventions.
After surgery, the patient is closely monitored in the intensive care unit (ICU) for a period of time to ensure stability and recovery. This may involve being on a ventilator, receiving medications for pain and to prevent infection, and undergoing physical therapy to regain strength.
Once the patient is stable, they are transferred to a regular hospital room where they continue to recover and receive care from nurses, doctors, and other healthcare professionals. This may involve monitoring vital signs, managing pain, and gradually increasing activity levels.
After discharge from the hospital, the patient will continue to follow up with their healthcare team for ongoing monitoring and rehabilitation. This may involve medications, lifestyle changes, and physical therapy to ensure a full recovery and optimal long-term outcomes.
What to Ask Your Doctor
Some questions a patient should ask their doctor about cardiac surgery include:
- What specific type of heart surgery do I need?
- What are the risks and benefits of this surgery for me?
- How experienced are you and your team in performing this type of surgery?
- What is the success rate of this surgery at this hospital/surgical group?
- How long will it take me to recover from the surgery?
- What kind of follow-up care will I need after the surgery?
- What are the potential complications or side effects of this surgery?
- Are there any alternative treatment options for my condition?
- How will my overall health and any other medical conditions I have affect the outcome of the surgery?
- How can I best prepare for the surgery, both physically and emotionally?
These questions can help patients make informed decisions about their cardiac surgery and understand what to expect before, during, and after the procedure.
Reference
Authors: Shahian DM, Badhwar V, Kurlansky PA, Bowdish ME, Lobdell KW, Furnary AP, Thourani VH, Jacobs JP, Wyler von Ballmoos MC, Kim KM, Vassileva C, Antman MS, Grau-Sepulveda MV, O’Brien SM. Journal: Ann Thorac Surg. 2022 Aug;114(2):467-475. doi: 10.1016/j.athoracsur.2021.06.084. Epub 2021 Aug 8. PMID: 34370982