Evaluation of quality of care for patients with congenital heart disease using ECHSA Congenital Database integrated tools

Abstract

Background. A quality of surgical care evaluation based solely on workload and hospital mortality is incomplete. ECHSA Congenital Database integrated tools provide complexity-adjusted methods to evaluate surgical results and the surgical performance of a hospital, and make it possible to demonstrate hospital service level among other congenital heart programmes.Methods. Data on 2,521 operations in a population of children, including 532 newborns, with congenital heart disease (CHD) were uploaded on the European Congenital Heart Surgeons Association Congenital Database. These data were collected between 2012 and 2018 at the Filatov Children's Hospital. We compared our personal results with database mean values according to the following criteria: 1) proportion of newborns among all paediatric surgical cases, 2) hospital mortality, 3) Aristotle Basic Score (ABS) value, 4) STS-EACTS Mortality Score (MtS) value, and 5) MtS Performance value. All data on the database website were analysed using integrated database tools.Results. The proportion of newborns in the Filatov Children's Hospital was 21.1%, while the database mean value was 18.6%, and hospital mortality values were 3.89% and 3.61%, respectively. The mean ABS in the Filatov Children's Hospital was 6.78 ± 2.08, while that on the database was 6.57 ± 2.12 (Z-score = 0.075). The mean MtS values for the hospital and database were 0.74 ± 0.59 and 0.72 ± 0.64, respectively (Z-score = 0.031). The calculated MtS performance for the Filatov Children's Hospital was 0.72 ± 0.56, while that for all European respondents was 0.54 ± 0.29 (Z-score = 0.603).Conclusion. Cooperation with a multicentre international database, such as ECHSA Congenital Database, provides modern complexity-adjusted tools for evaluation of quality of care for children with CHD. The Filatov Children’s Hospital is a high-volume cardiac surgery centre that demonstrates an adequate survival rate regarding complexity level and surgical risk compared to European respondents of the ECHSA Congenital Database. Received 19 October 2020. Revised 18 November 2020. Accepted 19 November 2020. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest.