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Heart Procedures


Cardiovascular procedures include heart and circulatory system procedures. Many indicators in the surgery and infection control sections also apply to cardiovascular procedures. These indicators include various complication rates and death rates, and summarize how well certain recommended approaches to these procedures are followed. At Norton Healthcare, only Norton Audubon Hospital and Norton Hospital perform open heart and interventional cardiology procedures on adults. Kosair Children’s Hospital performs open heart procedures on patients with congenital heart defects. Norton Healthcare performance represents the performance of all the hospitals combined.

AICDs (automatic implantable cardioverter defibrillators) - percent of patients
Number of automatic implantable cardioverter defibrillator (AICD), a device that monitors a person's heart rate and corrects it if it becomes irregular, patients with left ventricular systolic dysfunction (LVSD), a particular form of heart failure, per 100, who were prescribed an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB), a class of drugs used in the treatment of heart failure, upon discharge from the hospital. ACEI therapy improves survival for heart attack / heart irregularity patients. Recent medical recommendations also include angiotensin II receptor blocker (ARB) therapy. Includes patients with a procedure of AICD and with moderate or severe systolic dysfunction (decreased filling pressure congestion). Excludes patients with contraindication to both ACEI and ARB, and patients who died.(ACC) with LVSD given ACE or ARB at discharge high 75.9 # 79.2     76.9    
Number of automatic implantable cardioverter defibrillator (AICD), a device that monitors a person's heart rate and corrects it if it becomes irregular, patients who had a previous heart attack, per 100, who had beta blocker, a class of drugs that relieves stress on the heart, prescribed upon discharge from the hospital. Use of beta blockers lowers the risk of heart attacks. Includes patients with a procedure of AICD and with a previous heart attack. Excludes patients with contraindication to beta blocker, and patients who died.(ACC) with a previous heart attack given beta blocker at discharge high 98.0 # 88.7     93.0    
Number of automatic implantable cardioverter defibrillator (AICD), a device that monitors a person's heart rate and corrects it if it becomes irregular, patients with left ventricular systolic dysfunction (LVSD), a particular form of heart failure, per 100, who had beta blocker, a class of drugs that relieves stress on the heart, prescribed upon discharge from the hospital. Use of beta blockers lowers the risk of heart attacks and serious irregular heart rhythms. Includes patients with a procedure of AICD and with moderate or severe systolic dysfunction (decreased filling pressure congestion). Excludes patients with contraindication to beta blocker, and patients who died.(ACC) with LVSD given beta blocker at discharge high 90.9 # 87.3     89.3    
Number of automatic implantable cardioverter defibrillator (AICD), a device that monitors a person's heart rate and corrects it if it becomes irregular, patients per 100, who had an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB), a class of drugs used in the treatment of heart failure, and a beta blocker prescribed upon discharge from the hospital (however many of the 2 the patient was eligible for). This 'all or none' performance measure reports the percent of AICD patients with a prescription of discharge medications for which they were eligible. Includes patients with a procedure of AICD. Excludes patients with a contraindication to ACEI, ARB and beta blocker, and patients who died.(ACC) given ACE/ARB and beta blocker (all they are eligible for) at discharge high 68.1 # 75.6     71.3    
Cardiac catheterizations - percent of
Number of cardiac catheterizations per 100 that are bilateral (examine both sides of the heart). A cardiac catheterization involves the insertion of a catheter into a blood vessel in order to obtain information about how the heart is functioning. Bilateral catheterizations are not recommended for most patients. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Includes inpatient discharges with a procedure of heart catheterization and a diagnosis of coronary artery disease.(AHRQ IQI 25) procedures that are bilateral low 0.2 1.0 0.8 0Quality Ribbon   0.5   1.7
Number of elective cardiac catheterizations per 100, that show less than 50% blockage in all examined coronary vessels. These procedures are performed for many patients with coronary artery disease, in order to diagnose the severity of their disease. These procedures are not without risk, however, so they should be performed on patients who are most likely to have significant heart disease (greater than 50% blockage in at least one coronary vessel). Includes patients with an elective procedure of left heart catheterization (cardiac cath). Excludes patients with a prior CABG, cardiac caths for cardiac transplant evaluation, cardiac caths for pre-operative evaluation for non-cardiac surgery, and diagnostic cardiac cath treatment recommendation of other cardiac therapy without CABG or PCI.(ACC) elective procedures showing insignificant heart disease low 45.6 49.4 46.5 #   46.7    
Number of diagnostic cardiac catheterization procedures per 100, which developed a vascular access site injury requiring treatment or major bleeding. Vascular complications after cardiac catheterizations increase the long-term risk of adverse cardiac events, including heart attacks. Includes patients with a procedure of diagnostic cardiac catheterization.(ACC) patients with cath access site injury requiring treatment or major bleeding low 0.1 0.3 0Quality Ribbon 0Quality Ribbon   0.1    
PCIs (angioplasties) -
Median time from arrival at transferring hospital to arrival at receiving hospital, for heart attack patients transferred in and receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing. Early use of PCI in patients suffering a heart attack increases their survival rate. This indicator applies to patients who had a heart attack before arriving at the hospital and who were transferred from another hospital. The time measured is the time from the transferring facility ED arrival time to the receiving facility ED arrival time. Includes patients transferred in with a principal diagnosis of AMI with ST segment elevation (STEMI) who had PCI performed.(ACC) median facility to facility transfer time for heart attack patients low 90 80 75     77    
Median time from arrival at transferring hospital to time of PCI completion, for heart attack patients transferred in and receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing. Early use of PCI in patients suffering a heart attack increases their survival rate. This indicator applies to patients who had a heart attack before arriving at the hospital and who were transferred from another hospital. Includes patients transferred in with a principal diagnosis of AMI with ST segment elevation (STEMI) who had PCI performed. Excludes patients who have non-clinical reasons for delay documented.(ACC) median initial ED arrive to PCI time for transferred heart attack patients low 130 126 104     115    
Median time from hospital arrival to time of PCI completion, for heart attack patients receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing. Early use of PCI in patients suffering a heart attack increases their survival rate. This indicator applies to patients who had a heart attack before arriving at the hospital and to patients who had a heart attack while already in the hospital. Includes patients with a principal diagnosis of AMI with ST segment elevation (STEMI) and inpatients with a secondary diagnosis of AMI with STEMI, who had PCI performed. Excludes patients that were transferred from another hospital or who have non-clinical reasons for delay documented.(ACC) median time to immediate PCI for heart attack patients low 61 63 58     61    
Number of heart attack patients receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing, per 100, who received the PCI within 90 minutes of hospital arrival or, if already in the hospital, within 90 minutes of identification of the heart attack. Early use of PCI in patients suffering a heart attack increases their survival rate. This indicator applies to patients who had a heart attack before arriving at the hospital and to patients who had a heart attack while already in the hospital. Includes patients with a principal diagnosis of AMI with ST segment elevation (STEMI) and inpatients with a secondary diagnosis of AMI with STEMI, who had PCI performed. Excludes patients that were transferred from another hospital or who have non-clinical reasons for delay documented.(ACC) % heart attack / PCI patients treated w/in 90 minutes high 100.0Quality Ribbon # 100.0Quality Ribbon     99.2    
Number of elective percutaneous coronary intervention (PCI) procedures per 100, that had a prior positive stress test or imaging study. Includes patients with an elective procedure of PCI. Excludes patients with acute coronary syndrome (ACS).(ACC) % patients with positive stress or imaging study prior to elective PCI high # # #     #    
Median fluoro time for patients receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing, of one vessel/lesion. Includes patients with a procedure of PCI on one vessel/lesion. Excludes patients who had a prior CABG or other procedure during the same lab visit.(ACC) median fluoro time low 9 11 11     10    
Number of percutaneous coronary intervention (PCI) procedures per 100, which developed a vascular access site injury requiring treatment or major bleeding. Vascular complications after PCI increase the long-term risk of adverse cardiac events, including heart attacks. Includes patients with a procedure of PCI. Excludes patients with a heart bypass graft surgery or other surgery during the same admission.(ACC) % patients with PCI access site injury requiring treatment or major bleeding low 1.5 1.8 1.0     1.4    
Number of percutaneous coronary intervention (PCI) patients per 100, who had emergency heart bypass graft surgery. Includes patients with a procedure of PCI.(ACC) % patients who undergo emergency heart bypass graft surgery low 0.3 0Quality Ribbon 0.2     0.2    
Number of percutaneous coronary intervention (PCI) procedures per 100, with a post-procedure heart attack. Includes patients with an elective procedure of PCI. Excludes patients with a length of stay of less than 1 day.(ACC) % patients with post-procedure heart attack low 0Quality Ribbon 0Quality Ribbon 0Quality Ribbon     0Quality Ribbon    
Number of percutaneous coronary intervention (PCI) procedures per 100, with acute kidney injury. Includes patients with a procedure of PCI. Excludes patients on dialysis pre-procedure, and patients with a length of stay of less than 1 day.(ACC) % patients with acute kidney injury low 2.8 0.6 2.2     2.3    
Number of percutaneous coronary intervention (PCI) procedures per 100, with post-procedure stroke. Includes patients with a procedure of PCI.(ACC) % patients with post-procedure stroke low 0.4 0Quality Ribbon 0.6     0.4    
Number of percutaneous coronary intervention (PCI) patients per 100, with death, emergency heart bypass graft surgery, stroke, or repeat target vessel revascularization. Includes patients with a procedure of PCI. Excludes patients with stroke and an elective, urgent or salvage heart bypass graft surgery during the same admission.(ACC) % patients with emergency heart bypass graft surgery, stroke or repeat PCI low 1.6 3.1 1.9     1.8    
Number of percutaneous coronary intervention (PCI) patients per 100, who had aspirin prescribed upon discharge from the hospital. Includes patients with a procedure of PCI. Excludes patients with a documented contraindication to aspirin, and patients who died.(ACC) % patients given aspirin at discharge high 99.6 99.4 97.9     99.0    
Number of percutaneous coronary intervention (PCI) patients treated with stents per 100, who had Thienopyridine (Plavix, an antiplatelet drug) prescribed upon discharge from the hospital. Antiplatelet drugs interfere with the blood's ability to clot. These drugs are used to prevent blood clots, which can lead to heart attack or stroke, and which are more likely to occur in coronary vessels which have been treated with stents. Includes patients with a procedure of PCI with a stent implanted. Excludes patients with a documented contraindication to Plavix, and patients who died.(ACC) % stented patients given anti-platelets at discharge high 99.4 100.0Quality Ribbon 98.5     99.1    
Number of percutaneous coronary intervention (PCI) patients per 100, who had statins prescribed upon discharge from the hospital. Includes patients with a procedure of PCI. Excludes patients with a documented contraindication to statins, and patients who died.(ACC) % patients with high cholesterol given anti-lipid medication at discharge high 95.8 96.3 90.0     93.9    
Number of percutaneous coronary intervention (PCI) patients per 100, who had aspirin, Thienopyridine (Plavix, an antiplatelet drug), and a statin prescribed upon discharge from the hospital (however many of the 3 the patient was eligible for). This new 'all or none' performance measure reports the percent of PCI patients with a prescription of discharge medications for which they were eligible. Includes patients with a procedure of PCI. Excludes patients with a documented contraindication to aspirin, Plavix or statins, and patients who died.(ACC) % patients given aspirin, anti-platelet, and anti-lipid medication at discharge high 94.2 93.1 88.3     92.0    
Number of percutaneous coronary intervention (PCI) patients per 100, who died in the hospital. These procedures are performed for some patients with coronary artery disease. Many times these procedures involve the insertion of a balloon to open the artery and the placement of a stent to keep the artery open. Risk-adjusted using patient age, admission diagnoses, and other risk factors. Includes patients with a procedure of PCI.(ACC) % patients who die (ACC risk-adjusted) low 1.8 3.6 1.8          
Number of percutaneous coronary intervention (PCI) patients per 100, who died in the hospital. These procedures are performed for some patients with coronary artery disease. Many times these procedures involve the insertion of a balloon to open the artery and the placement of a stent to keep the artery open. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Includes inpatients 40 years and older discharged with a procedure of PCI. Excludes patients with missing discharge dispositions or patients transferred to an acute care hospital.(NQF HC 10 / AHRQ IQI 30) % patients who die (AHRQ risk-adjusted) low 0.65 2.70 0.85     0.97   1.64
Number of heart attack patients receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing, per 100, who died in the hospital. These procedures are performed for some patients with coronary artery disease. Many times these procedures involve the insertion of a balloon to open the artery and the placement of a stent to keep the artery open. Risk-adjusted using patient age, admission diagnoses, and other risk factors. Includes patients with a principal diagnosis of AMI with ST segment elevation (STEMI) and inpatients with a secondary diagnosis of AMI with STEMI, who had PCI performed.(ACC) % heart attack / PCI patients who die (ACC risk-adjusted) low 10.0 14.6 3.9          
Number of non heart attack patients receiving percutaneous coronary intervention (PCI), a procedure to relieve coronary narrowing, per 100, who died in the hospital. These procedures are performed for some patients with coronary artery disease. Many times these procedures involve the insertion of a balloon to open the artery and the placement of a stent to keep the artery open. Risk-adjusted using patient age, admission diagnoses, and other risk factors. Includes patients with no principal or secondary diagnoses of AMI with ST segment elevation (STEMI), who had PCI performed.(ACC) % non heart attack / PCI patients who die (ACC risk-adjusted) low 0Quality Ribbon 0Quality Ribbon 1.2          
PCIs (angioplasties) volume
Number of percutaneous coronary intervention procedures per year. These procedures are performed for some patients with coronary artery disease. Many times these procedures involve the insertion of a balloon to open the artery and the placement of a stent to keep the artery open. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients 40 years and older discharged with a procedure of PCI.(NQF HC 9 / AHRQ IQI 6) number of PCIs (AHRQ) high 496 134 311     941   200
Heart bypass (only) surgeries - percent of patients
Number of heart bypass surgical patients per 100 who received beta blockers within 24 hours before surgery. Beta blockers given before heart surgery reduce the risk of certain heart complications during the surgery. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age, patients having a contraindication to beta blocker therapy documented in the medical record by a physician, nurse practitioner or physician assistant, and patients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 5 / STS) given preoperative beta blocker high 95   98     96    
Number of heart bypass patients per 100, who received antibiotics for infection prevention within the recommended time before surgical incision (one hour for most antibiotics). This recommended time is most effective for preventing surgical infections. Includes patients who had a coronary artery bypass graft or other open heart surgery. Excludes patients who had a principal or admission diagnosis suggestive of infection before surgery, patients who received antibiotics at time of admission or more than 24 hours prior to surgery.(JC / CMS SIP1b,SIP1c) given preoperative antibiotic on time (CMS) high 99   97   # 98 99 99
Number of heart bypass patients per 100, who received recommended prophylactic antibiotics, measures to prevent infection, for the cardiac procedures. The recommended antibiotics are most effective for preventing surgical infections. Includes patients who had a coronary artery bypass graft or other open heart surgery. Excludes patients who had a principal or admission diagnosis suggestive of infection before surgery, patients who received antibiotics at time of admission or more than 24 hours prior to surgery, patients not receiving any prophylactic antibiotic, and patients who did not receive any antibiotics during hospitalization.(JC / CMS SIP2b,SIP2c) given recommended preoperative antibiotic (CMS) high 100Quality Ribbon   100Quality Ribbon   # 100Quality Ribbon 100 100
Number of heart bypass patients per 100, whose prophylactic antibiotics, measures to prevent infection, were discontinued within 24 hours after surgery end time. A brief course of prophylactic antibiotics is as effective as longer courses. Includes patients who had coronary artery bypass graft or other open heart surgery. Excludes patients who had a principal or admission diagnosis suggestive of infection before surgery, patients diagnosed and treated for infections within 2 days after surgery date, patients who received antibiotics at time of admission or more than 24 hours prior to surgery, patients not receiving any prophylactic antibiotic, and patients who did not receive any antibiotics during hospitalization.(JC/ CMS SIP3b,SIP3c) with antibiotic discontinued on time (CMS) high 97   100Quality Ribbon   # 98 99 99
Number of heart bypass procedures per 100, which use the internal mammary artery as a graft. This is a common open heart surgery where surgeons bypass blockages of the coronary arteries using the internal mammary artery as a graft. The use of an internal mammary artery increases the likelihood of a good long-term outcome for the patient. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age; excludes patients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy); and excludes patients with any previous CABG procedure.(NQF HC 11 / NQF cardiac 6 / STS) whose surgery used internal mammary artery high 98   97     97    
Number of heart bypass surgical patients per 100 who were intubated (kept on a ventilator) more than 24 hours. Shorter mechanical ventilation following coronary artery bypass graft (CABG) surgery is associated with lower risk of complications. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 8 / STS) intubated more than 24 hours (STS risk-adj.) low 8.7   11.1     9.6    
Number of heart bypass surgical patients per 100 who had a surgical re-exploration. Surgical re-exploration (follow-up surgery during the same admission) is a major complication of coronary artery bypass graft (CABG) surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 12 / STS) with surgical re-exploration (STS risk-adj.) low 7.0   5.3     6.4    
Number of heart bypass surgical patients per 100 who developed a deep sternal (chest) wound infection (infx). Deep sternal wound infection is a life-threatening complication of coronary artery bypass graft (CABG) surgery, particularly in diabetic patients. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 9 / STS) with deep sternal wound infection (STS risk-adj.) low 0.32   0Quality Ribbon     0.21    
Number of heart bypass surgical patients per 100 who had a permanent stroke or other cerebrovascular accident (CVA), an interruption of blood supply to part of the brain. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 10 / STS) with stroke/CVA (STS risk-adj.) low 2.18   0Quality Ribbon     1.36    
Number of heart bypass surgical patients per 100 who had renal insufficiency. Renal (kidney) insufficiency is a common complication after cardiac surgical procedures and is associated with higher mortality. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy); also excludes patients with preoperative dialysis.(NQF cardiac 11 / STS) with post-op. renal insufficiency (STS risk-adj.) low 2.1   2.2     2.1    
Number of heart bypass surgical patients per 100 who were given anti-platelets at discharge. Anti-platelets (blood thinners, like aspirin) are associated with a lower rate of graft occlusion (the closing up of the grafted artery) following coronary artery bypass graft (CABG) surgery. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age, patients having a contraindication to anti-platelets documented in the medical record by a physician, nurse practitioner or physician assistant, patients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy), and patients who died.(NQF cardiac 13 / STS) given anti-platelets at discharge high 98   97     98    
Number of heart bypass surgical patients per 100 who were given beta blocker at discharge. Beta blockers are medications which reduce the risk of a further heart attack in people who have already had one and have been shown to increase survival of cardiac patients. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age, patients having a contraindication to beta blocker therapy documented in the medical record by a physician, nurse practitioner or physician assistant, patients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy), and patients who died.(NQF cardiac 14 / STS) given beta blocker at discharge high 99   99     99    
Number of heart bypass surgical patients per 100 who were given anti-lipid medications at discharge. Lipid-lowering medications, which block the production of cholesterol and fat, have been associated with reductions in coronary heart disease mortality. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age, patients having a contraindication to anti-lipid medications documented in the medical record by a physician, nurse practitioner or physician assistant, patients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy), and patients who died.(NQF cardiac 15 / STS) given anti-lipid medication at discharge high 96   95     95    
Number of heart bypass surgical patients per 100 who died during the hospitalization in which the surgery occurred. For this mortality indicator only, STS does not risk-adjust and does not provide risk-adjusted comparative data. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 16 / NQF HC 13 / STS) with inpatient death low 2.2   0.7     1.6    
Number of heart bypass surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 17 / NQF HC 13 / STS) with operative death (STS risk-adj.) low 3.3   0.7     2.4    
Number of coronary artery bypass graft (CABG) patients per 100, who died in the hospital. This is a common open heart surgery where surgeons bypass blockages of the coronary arteries. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Includes inpatients 40 years and older discharged with a procedure of CABG. Excludes patients with missing discharge dispositions or patients transferred to an acute care hospital.(NQF HC 13 / NQF cardiac 16 / AHRQ IQI 12) who die (AHRQ risk-adj.) low 1.5   0.8     1.3   2.6
Cardiovascular procedures volumes - number of
Number of isolated heart bypass surgical procedures per year. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age and inpatients discharged with any valve procedure, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF HC 12 / NQF cardiac 2a / STS) heart bypass (only) surgical procedures per year high 230   152     382    
Number of isolated heart valve surgical procedures per year. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients discharged with any valve procedure (aortic, mitral, tricuspid or pulmonic). Excludes patients less than 20 years of age and inpatients discharged with any coronary artery bypass graft procedure (CABG), any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 2b / STS) heart valve (only) surgical procedures per year high 35   38     73    
Number of heart bypass surgical procedures per year. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG). Excludes patients less than 20 years of age.(The Leapfrog Group) heart bypass (total) surgical procedures per year high 317   183     500   450
Number of combined heart bypass and heart valve surgical procedures per year. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG) and any valve procedure (aortic, mitral, tricuspid or pulmonic). Excludes patients less than 20 years of age and inpatients discharged with any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 2c / STS) combined heart bypass + valve surgical procedures high 67   24     91    
Number of coronary artery bypass graft procedures per year. This is a common open heart surgery where surgeons bypass blockages of the coronary arteries. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients 40 years and older discharged with a procedure of CABG.(NQF HC 12 / NQF cardiac 2d / AHRQ IQI 5) coronary artery bypass grafts (CABGs; AHRQ defn.) high 300   174     474   100
Number of carotid endarterectomy procedures per year. This procedure removes plaque build up from the carotid artery which supplies blood and oxygen to the brain. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients discharged with a procedure of carotid endarterectomy.(AHRQ IQI 7) carotid endarterectomy surgical proceds. (AHRQ defn.) high 70 17 21 15   123   50
Number of abdominal aortic aneurysm (AAA) repairs per year. The abdominal aorta is part of the body’s largest blood vessel, and it carries blood to the stomach, pelvis, and legs. If its wall becomes weak, a bulge may occur and surgery might be necessary. Some research suggests higher volumes are associated with better patient outcomes, but it is controversial whether volume alone has any role as a useful quality indicator. Includes inpatients 18 years and older discharged with a diagnosis of AAA and a procedure of AAA repair.(AHRQ IQI 4) abdominal aortic aneurysm repairs (AHRQ defn.) high 32 0 28 0   60   10
Cardiovascular surgery mortality - percent of patients who die
Number of aortic heart valve replacement surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any aortic valve replacement procedure. Excludes patients less than 20 years of age and inpatients discharged with any coronary artery bypass graft procedure (CABG), any valve procedure other than aortic, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 18 / STS) during aortic valve replacement (STS adj) low 0Quality Ribbon   #     0Quality Ribbon    
Number of mitral heart valve replacement surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any mitral valve replacement procedure. Excludes patients less than 20 years of age and inpatients discharged with any coronary artery bypass graft procedure (CABG), any valve procedure other than mitral, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 19 / STS) during mitral valve replacement (STS adj) low #   #     #    
Number of mitral heart valve repair surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any mitral valve repair procedure. Excludes patients less than 20 years of age and inpatients discharged with any coronary artery bypass graft procedure (CABG), any valve procedure other than mitral, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 22 / STS) during mitral valve repair (STS adj) low #   #     #    
Number of combined heart bypass and aortic valve replacement surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG) and any aortic valve replacement procedure. Excludes patients less than 20 years of age and inpatients discharged with any valve procedure other than aortic, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 20 / STS) during heart bypass + aortic valve replacement (STS adj) low 0Quality Ribbon   #     1.7    
Number of combined heart bypass and mitral valve replacement surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG) and any mitral valve replacement procedure. Excludes patients less than 20 years of age and inpatients discharged with any valve procedure other than mitral, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 21 / STS) during heart bypass + mitral valve replacement (STS adj) low #   #     3    
Number of combined heart bypass and mitral valve repair surgical patients per 100 who died either during the hospitalization in which the surgery occurred or after that hospitalization but within 30 days of the surgery, unless the cause of death is clearly unrelated to the surgery. Risk-adjusted for patient demographics, medical history factors, severity of heart disease. Includes inpatients discharged with any coronary artery bypass graft procedure (CABG) and any mitral valve repair procedure. Excludes patients less than 20 years of age and inpatients discharged with any valve procedure other than mitral, any cardiac procedure other than CABG and/or valve, or any non-cardiac procedure performed on the great vessels (e.g., carotid endarterectomy).(NQF cardiac 23 / STS) during heart bypass + mitral valve repair (STS adj) low #   #     #    
Number of carotid endarterectomy patients per 100, who died in the hospital. This procedure removes plaque build up from the carotid artery, which supplies blood and oxygen to the brain. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Excludes patients with missing discharge dispositions or patients transferred to an acute care hospital.(AHRQ IQI 31) during or after carotid endarterectomy (AHRQ risk-adj) low 0Quality Ribbon # 0Quality Ribbon #   0Quality Ribbon   0.50
Number of abdominal aortic aneurysm (AAA) repair patients per 100, who died in the hospital. The abdominal aorta is part of the body’s largest blood vessel; if its wall becomes weak, a bulge may occur and surgery might be necessary. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Includes inpatients discharged with a diagnosis of AAA and a procedure of AAA repair. Excludes patients with missing discharge dispositions or patients transferred to an acute care hospital.(AHRQ IQI 11) during or after AAA repair (AHRQ risk-adj) low 0Quality Ribbon   0Quality Ribbon     0Quality Ribbon   4.6
Miscellaneous
Indication of whether the hospital is in a national cardiac surgery database or not. By committing to collecting outcomes (e.g., complications, mortality) data for a national database, hospitals are committing to improving the quality of care that their cardiac surgery patients receive.(NQF cardiac 1 / STS) Is the hospital in a national cardiac surgery database? high yes   yes   yes yes    

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