STS CABG Composite Quality Rating. Participant STS Period Ending 12/31/2016

Transcription

1 STS CABG Composite Quality Rating Quality Participant Score STS Mean Participant Distribution of Participant Scores Domain (98% CI) Participant Score Rating = STS Mean Jan 06 - Dec 06 Overall Jan 06 - Dec 06 Absence of Mortality Jan 06 - Dec 06 Absence of Morbidity Jan 06 - Dec 06 Use of IMA Jan 06 - Dec 06 Medications * = Participant performance is significantly lower than the STS mean based on 99% Bayesian probability * * = Participant performance is not significantly different than the STS mean based on 99% Bayesian probability * * * = Participant performance is significantly higher than the STS mean based on 99% Bayesian probability Please refer to Report Overview - STS Composite Quality Rating and NQF-Endorsed Measures for full details STS CABG Composite Quality Rating --

2 STS CABG Composite Quality Rating Domain Details Eligible Percent of Quality Domain Procedures Detail Count Morbidity/Failure Jan 06 - Dec 06 Absence of Mortality Mortality Jan 06 - Dec 06 Absence of Morbidity Any Morbidity Reoperation only 3... Renal Failure only 4... Deep Sternal Infection/Mediastinitis only... Prolonged Ventilation only... Cerebrovascular Accident only... Multiple Morbidities... Jan 06 - Dec 06 Use of IMA 5 IMA Failures Jan 06 - Dec 06 Medications 6 Failed to Prescribe all eligible NQF-Endorsed Medications Only Failed to Prescribe Preoperative Beta Blockade Only Failed to Prescribe Discharge Beta Blockade 7... Only Failed to Prescribe Discharge Anti-Lipids 7... Only Failed to Prescribe Discharge Anti-Platelets 8... Failed to Prescribe Multiple Medications... Percentages represent the proportion that the specific morbidity or process non-compliance contributed to the total number of patients for whom credit was not received for these 'all/any or none' bundles. This information is intended to facilitate and focus process and quality improvement initiatives by providers. Includes Reoperations, Renal Failure, Deep Sternal Infection/Mediastinitis, Prolonged Ventilation, and CVA 3 Includes Reoperations for Bleeding/Tamponade, Valvular Dysfunction, Graft Occlusion, and Other Cardiac Problems 4 Excludes patients with preop Renal Failure or Last Creatinine >= 4. 5 Excludes patients with prior CABG surgery and contraindications for IMA. Refer to Report Overview for definitions. 6 Includes Preoperative Beta Blockade, Discharge Beta Blockade, Discharge Anti-Lipids, and Discharge Anti-Platelets. Excludes contraindicated / not indicated records. 7 Excludes in-hospital mortalities 8 Anti-platelet use includes Aspirin, ADP Inhibitors, PY Antagonists and any other anti-platelet medications, and excludes in-hospital mortalities STS CABG Composite Quality Rating --

3 STS CABG Composite Quality Rating Rating Trend Quality Participant Rating Domain Jul 04 - Jun 05 Jan 05 - Dec 05 Jul 05 - Jun 06 Jan 06 - Dec 06 Overall Absence of Mortality Absence of Morbidity Use of IMA Medications * = Participant performance is significantly lower than the STS mean based on 99% Bayesian probability * * = Participant performance is not significantly different than the STS mean based on 99% Bayesian probability * * * = Participant performance is significantly higher than the STS mean based on 99% Bayesian probability Please refer to Report Overview - STS Composite Quality Rating and NQF-Endorsed Measures for full details Note: Star ratings for previous time periods reflect the results obtained at that time. Star ratings were not regenerated for those time periods using newer data STS CABG Composite Quality Rating -- 3

4 STS AVR Composite Quality Rating Quality Participant Score STS Mean Participant Distribution of Participant Scores Domain (95% CI) Participant Score Rating = STS Mean Jan 04 - Dec 06 Overall Jan 04 - Dec 06 Absence of Mortality Jan 04 - Dec 06 Absence of Morbidity * = Participant performance is significantly lower than the STS mean based on 97.5% Bayesian probability * * = Participant performance is not significantly different than the STS mean based on 97.5% Bayesian probability * * * = Participant performance is significantly higher than the STS mean based on 97.5% Bayesian probability Please refer to Report Overview - STS Composite Quality Rating and NQF-Endorsed Measures for full details STS AVR Composite Quality Rating -- 4

5 STS AVR Composite Quality Rating Domain Details Eligible Percent of Quality Domain Procedures Detail Count Morbidity/Failure Jan 04 - Dec 06 Absence of Mortality Mortality Jan 04 - Dec 06 Absence of Morbidity Any Morbidity Reoperation only 3... Renal Failure only 4... Deep Sternal Infection/Mediastinitis only... Prolonged Ventilation only... Cerebrovascular Accident only... Multiple Morbidities... Percentages represent the proportion that the specific morbidity or process non-compliance contributed to the total number of patients for whom credit was not received for these 'all/any or none' bundles. This information is intended to facilitate and focus process and quality improvement initiatives by providers. Includes Reoperations, Renal Failure, Deep Sternal Infection/Mediastinitis, Prolonged Ventilation, and CVA 3 Includes Reoperations for Bleeding/Tamponade, Valvular Dysfunction, Graft Occlusion, and Other Cardiac Problems 4 Excludes patients with preop Renal Failure or Last Creatinine >=4. STS AVR Composite Quality Rating -- 5

6 STS AVR + CABG Composite Quality Rating Quality Participant Score STS Mean Participant Distribution of Participant Scores Domain (95% CI) Participant Score Rating = STS Mean Jan 04 - Dec 06 Overall Jan 04 - Dec 06 Absence of Mortality Jan 04 - Dec 06 Absence of Morbidity * = Participant performance is significantly lower than the STS mean based on 97.5% Bayesian probability * * = Participant performance is not significantly different than the STS mean based on 97.5% Bayesian probability * * * = Participant performance is significantly higher than the STS mean based on 97.5% Bayesian probability Please refer to Report Overview - STS Composite Quality Rating and NQF-Endorsed Measures for full details STS AVR + CABG Composite Quality Rating -- 6

7 STS AVR + CABG Composite Quality Rating Domain Details Eligible Percent of Quality Domain Procedures Detail Count Morbidity/Failure Jan 04 - Dec 06 Absence of Mortality Mortality Jan 04 - Dec 06 Absence of Morbidity Any Morbidity Reoperation only 3... Renal Failure only 4... Deep Sternal Infection/Mediastinitis only... Prolonged Ventilation only... Cerebrovascular Accident only... Multiple Morbidities... Percentages represent the proportion that the specific morbidity or process non-compliance contributed to the total number of patients for whom credit was not received for these 'all/any or none' bundles. This information is intended to facilitate and focus process and quality improvement initiatives by providers. Includes Reoperations, Renal Failure, Deep Sternal Infection/Mediastinitis, Prolonged Ventilation, and CVA 3 Includes Reoperations for Bleeding/Tamponade, Valvular Dysfunction, Graft Occlusion, and Other Cardiac Problems 4 Excludes patients with preop Renal Failure or Last Creatinine >=4. STS AVR + CABG Composite Quality Rating -- 7

8 NQF-Endorsed Measures - CABG Process Measures Participant NQF-Endorsed Eligible Usage Participant Overall STS Distribution of Participant Values Measure Procedures (95% CI) Percentile Usage = Overall STS Usage Jan 06 - Dec 06 Preoperative Beta Blockade Therapy Jan 06 - Dec 06 Use of IMA Jan 06 - Dec 06 Discharge Anti-Platelet Medication 3 Jan 06 - Dec 06 Discharge Beta Blockade Therapy 4 Jan 06 - Dec 06 Discharge Anti-Lipid Treatment 4 Excludes contraindicated / not indicated records. Excludes patients with prior CABG surgery and contraindications for IMA. Refer to Report Overview for definitions. 3 Anti-platelet use includes Aspirin and ADP Inhibitors, and excludes in-hospital mortalities. Excludes contraindicated / not indicated records. 4 Excludes in-hospital mortalities. NQF Measures -- 8

9 NQF-Endorsed Measures - CABG Outcomes Measures Participant NQF-Endorsed Eligible Estimated Odds Ratio Participant Participant Distribution of Participant Values Measure Procedures (95% CI) Percentile Observed Rate = STS Estimated Odds Ratio Jan 06 - Dec 06 Deep Sternal Infection / Mediastinitis Jan 06 - Dec 06 Post-Op Renal Insufficiency (Failure) Jan 06 - Dec 06 Surgical Re-exploration Jan 06 - Dec 06 Stroke/ Cerebrovascular Accident Jan 06 - Dec 06 Prolonged Intubation (Ventilation) Excludes patients with preoperative dialysis or last creatinine >=4 Includes Reoperations for Bleeding/Tamponade, Valvular Dysfunction, Graft Occlusion, and Other Cardiac Problems NQF Measures -- 9

10 NQF-Endorsed Measures - All Cardiac Surgeries Process Measures Participant NQF-Endorsed Eligible Usage Participant Overall STS Distribution of Participant Values Measure Procedures (95% CI) Percentile Usage = Overall STS Usage Jan 06 - Dec 06 Duration of Antibiotic Prophylaxis Jan 06 - Dec 06 Selection of Antibiotic Prophylaxis Jan 06 - Dec 06 Timing of Antibiotic Prophylaxis 3 Prophylactic antibiotics discontinued within 48 hours First or second generation cephalosporin prescribed/given prophylactically 3 Appropriate timing of prophylactic antibiotics Note: Includes all cardiac surgeries. Refer to Report Overview for definitions. Note: All measures are among patients without exclusions. NQF Measures -- 0

11 NQF-Endorsed Measures Mortality Measures Participant NQF-Endorsed Eligible Estimated Odds Ratio Participant Participant Distribution of Participant Values Measure Procedures (95% CI) Percentile Observed Rate = STS Estimated Odds Ratio Jan 06 - Dec 06 CABG Inpatient Mortality Jan 06 - Dec 06 CABG Operative Mortality Jan 04 - Dec 06 AVR Operative Mortality Jan 04 - Dec 06 MVR Operative Mortality Jan 04 - Dec 06 MV Repair Operative Mortality NQF Measures --

12 NQF-Endorsed Measures Mortality Measures Participant NQF-Endorsed Eligible Estimated Odds Ratio Participant Participant Distribution of Participant Values Measure Procedures (95% CI) Percentile Observed Rate = STS Estimated Odds Ratio Jan 04 - Dec 06 AVR+CABG Operative Mortality Jan 04 - Dec 06 MVR+CABG Operative Mortality Jan 04 - Dec 06 MV Repair+CABG Operative Mortality NQF Measures --

13 Executive Summary Executive Summary -- 3

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16 Executive Summary Executive Summary -- 6

17 Executive Summary Yearly Number of Sites in Analysis Yearly Overall Procedure Count Major Procedures Isolated CABG... Isolated Aortic Valve Replacement... Isolated Mitral Valve Replacement... Aortic Valve Replacement + CABG... Mitral Valve Replacement + CABG... Aortic + Mitral Valve Replacements... Mitral Valve Repair... Mitral Valve Repair + CABG... Not Classified Above... Incidence of Other Procedures Pulmonic Valve... Tricuspid Valve... Ventricular Assist Device... LVA - Left Ventricular Aneurysm Repair VSD - Ventricular Septal Defect Repair. ASD - Atrial Septal Defect Repair... Batista... Surgical Ventricular Restoration... Congenital Defect Repair... Transmyocardial Laser Revascularization Cardiac Trauma... Cardiac Transplant... Arrhythmia Correction Surgery... Atrial Fibrillation Correction Surgery... Aortic Aneurysm... Ascending Aorta... Aortic Arch... Descending Aorta... Thoracoabdominal Aorta... Carotid Endarterectomy... Other Vascular... Other Thoracic... Executive Summary -- 7

18 Executive Summary -- 8

19 Major Procedures Mortality CABG, Valve, and Valve+CABG Procedures Combined Like Group STS Number of Cases Mortality Summary In-hospital Mortality... Operative Mortality... Mortality Risk-Adjustment In-hospital Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Operative Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Includes all 7 Major Procedure Categories (CABG, AVR, AVR+CABG, MVR, MVR+CABG, MVP, MVP+CABG) Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months Major Procedures -- 9

20 Major Procedures -- 0

21 Isolated CABG Procedures Like Group STS Number of Cases Demographics Age (years) Mean... Median... 5 th Percentile th Percentile... Age >= 65 years old... Gender, Female... Race Caucasian... Black... Asian... Native American... Native Hawaiian/Pacific Islander... Other... Multiple Races... Missing / Not Documented... Pt. Declined to Disclose... Hispanic or Latino or Spanish Ethnicity... Missing/ Not Documented... Body Mass Index 3 Underweight (BMI < 8.5)... Normal (BMI )... Overweight (BMI )... Obese I (BMI )... Obese II (BMI )... Morbid Obesity (BMI 40.0+)... Missing Height... Data presented in the report represent the individual response rates for each race category Missing Weight... shown; summing the individual non-caucasian categories will not result in the same rates as shown in the graph since non-caucasian, as defined for the graph, does not include races or CABG -- ethnicities reported in combination with caucasian Option added in v.8 3 BMI = Weight(kg) / Height(m)

22 Isolated CABG Procedures Like Group STS Comorbidities Diabetes Mellitus... Diet Control... Oral Control... Insulin Control... Other SQ Medication Control... Other Control... Missing Control... Hypertension... Dyslipidemia... Family History of CAD... Current/Recent Cigarette Smoker... Smoker, Current Status Unknown... Chronic Lung Disease Mild... Moderate... Severe... Unknown Severity... Congestive Heart Failure... CHF / NYHA Class I... CHF / NYHA Class II... CHF / NYHA Class III... CHF / NYHA Class IV... CHF / Missing Class... Peripheral Arterial Disease... Option added in v.8 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class CABG --

23 Isolated CABG Procedures Like Group STS Cerebrovascular Disease... Missing... Coma/Nonresponsive State... Missing... CVD TIA... Missing... Carotid Stenosis None % %... Missing/Not Documented... CVD Prior Carotid Surgery... Missing... Cerebrovascular Accident... Missing... Renal Failure, Dialysis-Dependent... Missing... Last Creatinine Preop... Mean... Median... 5 th Percentile th Percentile... Value >= 4.0 mg/dl... Immunosuppressive Treatment... Missing... Previous Interventions Previous Cardiac Surgery 3... First reoperation... Defined as highest level of occlusion in either carotid. Option added in v.8 3 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery Previous CABG... CABG -- 3

24 Isolated CABG Procedures Like Group STS Previous AICD... Previous Pacemaker... Previous PCI... <= 6 hours prior to surgery... > 6 hours prior to surgery... Missing timing... Previous PCI Stent... Status Surgery Status Elective... Urgent... Emergent... Emergent Salvage... MI... <= 7 days prior to surgery days prior to surgery... > days prior to surgery... Missing timing... Cardiogenic Shock At the time of surgery... Within 4 hrs of surgery... Resuscitation <= hr prior to surgery hrs prior to surgery... Option added in v.8 CABG -- 4

25 Isolated CABG Procedures Like Group STS Cardiac Pres. on Admission No Symptoms or Angina... Symptoms Unlikely to be Ischemia... Stable Angina... Unstable Angina... Non-ST Elevation MI (Non-STEMI)... ST Elevation MI (STEMI)... Angina Equivalent... Other... Any Arrhythmia 3... Recent... Remote... Ventricular Tachycardia/Fibrillation 4... Missing... 3 rd degree Heart Block 4... Missing... Atrial Fibrillation/Flutter 5... Missing... Atrial Fibrillation 4, 5... Missing... Atrial Flutter 4, 5... Missing... Hemodynamics and Catheterization Number of Diseased Coronary Vessels One... Two... Three... Left Main Disease (>=50% Stenosis)... Option dropped in v.8 Option added in v.8 3 Includes VTach/VFib, nd and 3 rd degree HB, Sick Sinus Syndrome, AFib, and AFlutter 4 For v.8 data, includes recent or remote arrhythmias 5 For v.8 data, AFib and AFlutter were separated. CABG -- 5

26 Isolated CABG Procedures Like Group STS Ejection Fraction Mean... Median... 5 th Percentile th Percentile... EF missing or not measured... EF <40%... Pulmonary Hypertension... PA mean/systolic pressure missing or not measured... Aortic Stenosis... Mitral Insufficiency Trivial... Mild... Moderate... Severe... Missing/Not Documented... Preoperative Medications Aspirin... Contraindicated / Not Indicated 3... Inotropics... Beta Blockers... Contraindicated / Not Indicated... Among patients with measured EF PA systolic pressure > 35mmHg 3 For v.73 data, the Contraindicated/Not Indicated option was deleted CABG -- 6

27 Isolated CABG Procedures Like Group STS Steroids... Contraindicated / Not Indicated... Nitrates IV... ACE Inhibitors... Contraindicated / Not Indicated... Anticoagulants... Coumadin... Lipid-Lowering agents... Contraindicated / Not Indicated... Glycoprotein IIb/IIIa Inhibitor... ADP Inhibitors within 5 Days... Contraindicated / Not Indicated... ADP Inhibitor Discontinuation < Day... Day... Days... 3 Days... 4 Days... 5 Days... For v.73 data, the Contraindicated/Not Indicated option was deleted Excludes patients not on ADP Inhibitors within 5 Days CABG -- 7

28 Isolated CABG Procedures Like Group STS Antiplatelets within 5 Days... Contraindicated / Not Indicated... Operative Information Blood Products Used... Number of Blood Product Units Used Red Blood Cell Unit... Red Blood Cell Units... 3 Red Blood Cell Units Red Blood Cell Units... + Fresh Frozen Plasma Units... + Cryoprecipitate Units... + Platelet Units... Number of Distal Anastamoses, Total Missing... Vein Harvest Technique 3 Endovascular/Endoscopic... Direct Vision... Both... Cryopreserved... Missing... Internal Mammary Artery Used 4 Any... Left... Right... Both... For v.73 data, the Contraindicated/Not Indicated option was deleted Where number of arterial conduits and number of vein grafts both missing 3 Where at least vein was harvested 4 Excludes patients with prior CABG surgery CABG -- 8

29 Isolated CABG Procedures Like Group STS Radial Artery Used... Radial Artery Harvest Technique... Endovascular/Endoscopic... Direct Vision... Both... Missing... IABP Used... Preop... Intraop... Postop... Missing Timing... Robotic Technology Assisted... Off-pump Procedure (see following section for detail)... Cross-Clamp Time (min) Mean... Median... 5 th Percentile th Percentile... Cardiopulmonary Bypass Time (min) Mean... Median... 5 th Percentile th Percentile... CABG -- 9

30 Isolated CABG Procedures Like Group STS Circulatory Arrest... Circulatory Arrest Time (min) Mean... Median... 5 th Percentile th Percentile... Skin Incision Duration (min) Mean... Median... 5 th Percentile th Percentile... OR Duration (min) Mean... Median... 5 th Percentile th Percentile... Antibiotic Selection,... Exclusions... Antibiotic Timing, 3... Exclusions... Antibiotics Discontinued,4... Exclusions... Clotting Agents 5... All antibiotic measures are calculated among patients without exclusions First or second generation cephalosporin prescribed/given prophylactically 3 Appropriate timing of prophylactic antibiotics 4 Prophylactic antibiotics discontinued within 48 hours 5 Includes one or more of the following: Aprotinin, Epsilon Amino-Caproic Acid, CABG Desmopressin, or Tranexamic Acid

31 Isolated CABG Procedures Like Group STS Postoperative Information Blood Products Used... Number of Blood Product Units Used Red Blood Cell Unit... Red Blood Cell Units... 3 Red Blood Cell Units Red Blood Cell Units... + Fresh Frozen Plasma Units... + Cryoprecipitate Units... + Platelet Units... Intraop/Postop Products Used... Total Number of Blood Product Units Red Blood Cell Unit... Red Blood Cell Units... 3 Red Blood Cell Units Red Blood Cell Units... + Fresh Frozen Plasma Units... + Cryoprecipitate Units... + Platelet Units... Ventilation Total Ventilation Hours Mean... Median... 5 th Percentile th Percentile... Initial Ventilation Hours Mean... Median... Initial Ventilation <6 hours... Extubated in OR... Excludes patients extubated in the OR Reintubation... CABG -- 3

32 Isolated CABG Procedures Like Group STS Additional Ventilation Hours Mean... Median... ICU Stay Total ICU Hours Mean... Median th Percentile... 5 th Percentile... Initial ICU Hours Mean... Median... Readmitted to ICU... Additional ICU Hours Mean... Median... Mortality Summary In-hospital Mortality... Operative Mortality... Mortality Risk-Adjustment 3 In-hospital Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Among patients reintubated Among patients readmitted to the ICU 3 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG -- 3

33 Isolated CABG Procedures Like Group STS Operative Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Complications Summary Any Complications... Any Major Complications / Operative Mortality... Operative Complications Any Reoperation... Any Reoperation (NQF Definition)... Reoperation for Bleeding... Reoperation for Valvular Dysfunction... Reoperation for Graft Occlusion... Reoperation for Other Cardiac... Reoperation for Other Non-Cardiac... Infection Complications Any Infection... Deep Sternal Infection/Mediastinitis... Septicemia/Sepsis... Conduit Harvest or Cannulation Site 3... Neurological Complications Any Neurological... Coma/Encephalopathy... Permanent Stroke... Includes reoperations for bleeding/tamponade, valvular dysfunction, graft occlusion, Transient Ischemic Attack... and other cardiac problems. Paralysis... Includes surgical and PCI/Transcatheter interventions 3 Excludes patients with zero vein grafts CABG -- 33

34 Isolated CABG Procedures Like Group STS Pulmonary Complications Any Pulmonary... Prolonged Ventilation... Pneumonia... Pulmonary Embolism... Pleural Effusion Requiring Drainage... Renal Complications Renal Failure... Vascular Complications Any Vascular... Acute Limb Ischemia... Other Complications Any Other... New Onset Atrial Fibrillation... Recent Recurrent Atrial Fibrillation 3... Cardiac Arrest... Anticoagulant Complication... Tamponade... Gastro-Intestinal Complication... Multi-System Failure... Complications Risk-Adjustment 4 Major Complications or Op. Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Excludes patients with preoperative dialysis or last creatinine >=4 New Onset AFib is only among patients with no history of arrhythmias 3 Recent Recurrent AFib is among patients with history of recent AFib 4 Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG -- 34

35 Isolated CABG Procedures Like Group STS Any Reoperation Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Deep Sternal Infection/Mediastinitis Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Permanent Stroke Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Renal Failure Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... CABG -- 35

36 Isolated CABG Procedures Like Group STS Prolonged Ventilation Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Discharge Location Home... Extended Care/TCU... Other Acute Care Hospital... Nursing Home... Hospice... Left AMA... Other... Discharge Medications Aspirin... Contraindicated / Not Indicated... ACE inhibitors... Contraindicated / Not Indicated... Beta Blockers... Contraindicated / Not Indicated... Any Lipid-Lowering Agents 3... Contraindicated / Not Indicated... Excludes in-hospital mortalities Option added in v.8 3 Variable dropped in v.8 CABG -- 36

37 Isolated CABG Procedures Like Group STS Statin Lipid-Lowering Agents... Contraindicated / Not Indicated... Non-Statin Lipid-Lowering Agents... Contraindicated / Not Indicated... ADP Inhibitors... Contraindicated / Not Indicated... PY Antagonists... Contraindicated / Not Indicated... Other Antiplatelets... Contraindicated / Not Indicated... Antiarrhythmics 3... Contraindicated / Not Indicated... Amiodarone... Contraindicated / Not Indicated... Coumadin... Contraindicated / Not Indicated... Variable added in v.8 For v.73 data, the Contraindicated/Not Indicated option was deleted 3 Variable dropped in v.8 CABG -- 37

38 Isolated CABG Procedures Like Group STS Discharge Referrals/Counseling Cardiac Rehabilitation Referral... Smoking Cessation Counseling... Readmission and Reason Readmitted within 30 Days 3... Anticoagulation Complication Valvular... Pharmacological... Arrhythmias/Heart Block... Congestive Heart Failure... MI and/or Recurrent Angina... Pericardial Effusion / Tamponade... Pneumonia or Other Respiratory Complication 4... Pneumonia 5... Respiratory Complications, Other 5... Pleural Effusion req. Intervention 5... Coronary Artery Dysfunction... Valve Dysfunction... Infection - Deep Sternum... Infection - Conduit Harvest Site... Renal Failure... TIA / Permanent CVA... Acute Vascular Complication... Subacute Endocarditis... VAD Complication... Other... Other - Planned readmission 5... Missing/Unknown... Excludes in-hospital mortalities and Not Applicable Records Excludes in-hospital mortalities 3 Timed from procedure for v.73, from discharge for v.8 4 Option dropped in v.8 5 Option added in v.8 CABG -- 38

39 Isolated CABG Procedures Like Group STS Length of Stay Summary Total Length of Stay (days) Mean... Median... 5 th Percentile th Percentile... Post-Procedure Length of Stay (days) Mean... Median... 5 th Percentile th Percentile... PLOS <6 days... PLOS >4 days... Length of Stay Risk-Adjustment Short stay: PLOS <6 days Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Long stay: PLOS >4 days Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG -- 39

40 Isolated CABG Procedures Subset: On-pump procedures Like Group STS Number of On-Pump Procedures Demographics Age (years), median... Gender, Female... Race, Non-caucasian... Multiple Races... Obesity (BMI 30.0+)... Comorbidities Diabetes Mellitus... Insulin-Dependent... Hypertension... Dyslipidemia... Current/Recent Cigarette Smoker... Chronic Lung Disease, Mild+... Congestive Heart Failure... CHF / NYHA class IV... Peripheral Arterial Disease... Cerebrovascular Disease... CVA... Renal failure, Dialysis-Dependent... Last Creatinine Preop >= 4.0 mg/dl... Immunosuppressive Treatment... Previous Interventions Previous Cardiac Surgery... Previous CAB... Previous PCI... Status Surgery status, Emergent or Salvage... MI... <= 7 days Prior to Surgery... Cardiogenic Shock... Resuscitation... NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG On-pump procedures -- 40

41 Isolated CABG Procedures Subset: On-pump procedures Like Group STS Hemodynamics and Catheterization Triple Vessel Disease... Left Main Disease (>=50% stenosis)... Ejection Fraction < 40%... Aortic Stenosis... Mitral Insufficiency, Mild+... Operative Information IABP, Preoperative... Cross-Clamp Time (min) Mean... Median... Cardiopulmonary Bypass Time (min) Mean... Median... Postoperative Information Ventilation hours, total Mean... Median... ICU hours, total Mean... Median... Mortality Summary & Risk-Adjustment In-hospital Mortality Observed rate... Risk-adjusted rate... Operative Mortality Observed rate... Risk-adjusted rate... Among patients with measured EF Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG On-pump procedures -- 4

42 Isolated CABG Procedures Subset: On-pump procedures Like Group STS Complications Summary & Risk-Adjustment Major Complications or Op. Mortality Observed Rate... Risk-adjusted Rate... Any Reoperation Observed Rate... Risk-adjusted Rate... Deep Sternal Infection/Mediastinitis Observed Rate... Risk-adjusted Rate... Permanent Stroke Observed Rate... Risk-adjusted Rate... Renal Failure Observed Rate... Risk-adjusted Rate... Prolonged Ventilation Observed Rate... Risk-adjusted Rate... Readmission 3 Readmitted within 30 days 4... Length of Stay Summary Total length of stay (days) Mean... Median... Post-procedure Length of Stay (days) Mean... Refer to the Report Overview for information on risk-adjustment methodology Median... Risk-adjustment is not performed on time periods of less than 6 months Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from procedure for v.73, from discharge for v.8 CABG On-pump procedures -- 4

43 CABG On-pump procedures -- 43

44 Isolated CABG Procedures Subset: Off-pump procedures Like Group STS Number of Off-Pump Procedures Demographics Age (years), median... Gender, Female... Race, Non-caucasian... Multiple Races... Obesity (BMI 30.0+)... Comorbidities Diabetes Mellitus... Insulin-Dependent... Hypertension... Dyslipidemia... Current/Recent Cigarette Smoker... Chronic Lung Disease, Mild+... Congestive Heart Failure... CHF / NYHA class IV... Peripheral Arterial Disease... Cerebrovascular Disease... CVA... Renal failure, Dialysis-Dependent... Last Creatinine Preop >= 4.0 mg/dl... Immunosuppressive Treatment... Previous Interventions Previous Cardiac Surgery... Previous CAB... Previous PCI... Status Surgery status, Emergent or Salvage... MI... <= 7 days Prior to Surgery... Cardiogenic Shock... Resuscitation... NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG Off-pump procedures -- 44

45 Isolated CABG Procedures Subset: Off-pump procedures Like Group STS Hemodynamics and Catheterization Triple Vessel Disease... Left Main Disease (>=50% stenosis)... Ejection Fraction < 40%... Aortic Stenosis... Mitral Insufficiency, Mild+... Operative Information IABP, Preoperative... Cross-Clamp Time (min) Mean Median Cardiopulmonary Bypass Time (min) Mean Median Postoperative Information Ventilation hours, total Mean... Median... ICU hours, total Mean... Median... Mortality Summary & Risk-Adjustment In-hospital Mortality Observed rate... Risk-adjusted rate... Operative Mortality Observed rate... Risk-adjusted rate... Among patients with measured EF Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG Off-pump procedures -- 45

46 Isolated CABG Procedures Subset: Off-pump procedures Like Group STS Complications Summary & Risk-Adjustment Major Complications or Op. Mortality Observed Rate... Risk-adjusted Rate... Any Reoperation Observed Rate... Risk-adjusted Rate... Deep Sternal Infection/Mediastinitis Observed Rate... Risk-adjusted Rate... Permanent Stroke Observed Rate... Risk-adjusted Rate... Renal Failure Observed Rate... Risk-adjusted Rate... Prolonged Ventilation Observed Rate... Risk-adjusted Rate... Readmission 3 Readmitted within 30 days 4... Length of Stay Summary Total length of stay (days) Mean... Median... Post-procedure Length of Stay (days) Mean... Refer to the Report Overview for information on risk-adjustment methodology Median... Risk-adjustment is not performed on time periods of less than 6 months Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from procedure for v.73, from discharge for v.8 CABG Off-pump procedures -- 46

47 CABG Off-pump procedures -- 47

48 Isolated CABG Procedures Subset: First Operations Like Group STS Number of First Operations Demographics Age (years), median... Gender, Female... Race, Non-caucasian... Multiple Races... Obesity (BMI 30.0+)... Comorbidities Diabetes Mellitus... Insulin-Dependent... Hypertension... Dyslipidemia... Current/Recent Cigarette Smoker... Chronic Lung Disease, Mild+... Congestive Heart Failure... CHF / NYHA class IV... Peripheral Arterial Disease... Cerebrovascular Disease... CVA... Renal failure, Dialysis-Dependent... Last Creatinine Preop >= 4.0 mg/dl... Immunosuppressive Treatment... Previous Interventions Previous Cardiac Surgery... Previous CAB... Previous PCI... Status Surgery status, Emergent or Salvage... MI... <= 7 days Prior to Surgery... Cardiogenic Shock... Resuscitation... NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG First Operations -- 48

49 Isolated CABG Procedures Subset: First Operations Like Group STS Hemodynamics and Catheterization Triple Vessel Disease... Left Main Disease (>=50% stenosis)... Ejection Fraction < 40%... Aortic Stenosis... Mitral Insufficiency, Mild+... Operative Information IABP, Preoperative... Cross-Clamp Time (min) Mean... Median... Cardiopulmonary Bypass Time (min) Mean... Median... Postoperative Information Ventilation hours, total Mean... Median... ICU hours, total Mean... Median... Mortality Summary & Risk-Adjustment In-hospital Mortality Observed rate... Risk-adjusted rate... Operative Mortality Observed rate... Risk-adjusted rate... Among patients with measured EF Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG First Operations -- 49

50 Isolated CABG Procedures Subset: First Operations Like Group STS Complications Summary & Risk-Adjustment Major Complications or Op. Mortality Observed Rate... Risk-adjusted Rate... Any Reoperation Observed Rate... Risk-adjusted Rate... Deep Sternal Infection/Mediastinitis Observed Rate... Risk-adjusted Rate... Permanent Stroke Observed Rate... Risk-adjusted Rate... Renal Failure Observed Rate... Risk-adjusted Rate... Prolonged Ventilation Observed Rate... Risk-adjusted Rate... Readmission 3 Readmitted within 30 days 4... Length of Stay Summary Total length of stay (days) Mean... Median... Post-procedure Length of Stay (days) Mean... Refer to the Report Overview for information on risk-adjustment methodology Median... Risk-adjustment is not performed on time periods of less than 6 months Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from procedure for v.73, from discharge for v.8 CABG First Operations -- 50

51 CABG First Operations -- 5

52 Isolated CABG Procedures Subset: Reoperations Like Group STS Number of Reoperations Demographics Age (years), median... Gender, Female... Race, Non-caucasian... Multiple Races... Obesity (BMI 30.0+)... Comorbidities Diabetes Mellitus... Insulin-Dependent... Hypertension... Dyslipidemia... Current/Recent Cigarette Smoker... Chronic Lung Disease, Mild+... Congestive Heart Failure... CHF / NYHA class IV... Peripheral Arterial Disease... Cerebrovascular Disease... CVA... Renal failure, Dialysis-Dependent... Last Creatinine Preop >= 4.0 mg/dl... Immunosuppressive Treatment... Previous Interventions Previous Cardiac Surgery... Previous CAB... Previous PCI... Status Surgery status, Emergent or Salvage... MI... <= 7 days Prior to Surgery... Cardiogenic Shock... Resuscitation... NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery CABG Reoperations -- 5

53 Isolated CABG Procedures Subset: Reoperations Like Group STS Hemodynamics and Catheterization Triple Vessel Disease... Left Main Disease (>=50% stenosis)... Ejection Fraction < 40%... Aortic Stenosis... Mitral Insufficiency, Mild+... Operative Information IABP, Preoperative... Cross-Clamp Time (min) Mean... Median... Cardiopulmonary Bypass Time (min) Mean... Median... Postoperative Information Ventilation hours, total Mean... Median... ICU hours, total Mean... Median... Mortality Summary & Risk-Adjustment In-hospital Mortality Observed rate... Risk-adjusted rate... Operative Mortality Observed rate... Risk-adjusted rate... Among patients with measured EF Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months CABG Reoperations -- 53

54 Isolated CABG Procedures Subset: Reoperations Like Group STS Complications Summary & Risk-Adjustment Major Complications or Op. Mortality Observed Rate... Risk-adjusted Rate... Any Reoperation Observed Rate... Risk-adjusted Rate... Deep Sternal Infection/Mediastinitis Observed Rate... Risk-adjusted Rate... Permanent Stroke Observed Rate... Risk-adjusted Rate... Renal Failure Observed Rate... Risk-adjusted Rate... Prolonged Ventilation Observed Rate... Risk-adjusted Rate... Readmission 3 Readmitted within 30 days 4... Length of Stay Summary Total length of stay (days) Mean... Median... Post-procedure Length of Stay (days) Mean... Refer to the Report Overview for information on risk-adjustment methodology Median... Risk-adjustment is not performed on time periods of less than 6 months Excludes patients with preoperative dialysis or last creatinine >=4 3 Excludes in-hospital mortalities 4 Timed from procedure for v.73, from discharge for v.8 CABG Reoperations -- 54

55 CABG Reoperations -- 55

56 Isolated Aortic Valve Replacement Procedures Like Group STS Number of Cases Demographics Age (years) Mean... Median... 5 th Percentile th Percentile... Age >= 65 years old... Gender, Female... Race Caucasian... Black... Asian... Native American... Native Hawaiian/Pacific Islander... Other... Multiple Races... Missing / Not Documented... Pt. Declined to Disclose... Hispanic or Latino Ethnicity... Missing/ Not Documented... Body Mass Index 3 Underweight (BMI < 8.5)... Normal (BMI )... Overweight (BMI )... Obese I (BMI )... Obese II (BMI )... Morbid Obesity (BMI 40.0+)... Missing Height... Data presented in the report represent the individual response rates for each race category Missing Weight... shown; summing the individual non-caucasian categories will not result in the same rates as shown in the graph since non-caucasian, as defined for the graph, does not include races or AV Replace ethnicities reported in combination with caucasian Option added in v.8 3 BMI = Weight(kg) / Height(m)

57 Isolated Aortic Valve Replacement Procedures Like Group STS Comorbidities Diabetes Mellitus... Diet Control... Oral Control... Insulin Control... Other SQ Medication Control... Other Control... Missing Control... Hypertension... Current/Recent Cigarette Smoker... Smoker, Current Status Unknown... Chronic Lung Disease Mild... Moderate... Severe... Unknown Severity... Congestive Heart Failure... CHF / NYHA Class I... CHF / NYHA Class II... CHF / NYHA Class III... CHF / NYHA Class IV... CHF / Missing Class... Peripheral Arterial Disease... Cerebrovascular Disease... Coma/Nonresponsive State... Missing... Option added in v.8 NYHA Class is only collected for patients with CHF % represents proportion of cases that had both CHF and the indicated NYHA class AV Replace -- 57

58 Isolated Aortic Valve Replacement Procedures Like Group STS CVD TIA... Missing... Carotid Stenosis None % %... Missing/Not Documented... CVD Prior Carotid Surgery... Missing... Cerebrovascular Accident... Missing... Renal Failure, Dialysis-Dependent... Last Creatinine Preop Mean... Median... 5 th Percentile th Percentile... Value >= 4.0 mg/dl... Immunosuppressive Treatment... Infectious Endocarditis... Previous Interventions Previous Cardiac Surgery 3... First reoperation... Previous CABG... Defined as highest level of occlusion in either carotid. Option added in v.8 3 Previous cardiac surgery reflects any prior CABG, valve, or other cardiac surgery Previous Valve... Previous AICD... AV Replace -- 58

59 Isolated Aortic Valve Replacement Procedures Like Group STS Previous Pacemaker... Status Surgery Status Elective... Urgent... Emergent... Emergent Salvage... MI... Cardiogenic Shock At the time of surgery... Within 4 hrs of surgery... Hemodynamics and Catheterization Ejection Fraction Mean... Median... 5 th Percentile th Percentile... EF missing or not measured... EF <40%... Pulmonary Hypertension 3... PA mean/systolic pressure missing or not measured... Aortic Stenosis... Aortic Insufficiency Trivial... Mild... Moderate... Severe... Missing/Not Documented... AV Replace Option added in v.8 Among patients with measured EF 3 PA systolic pressure > 35mmHg

60 Isolated Aortic Valve Replacement Procedures Like Group STS Preoperative Medications Aspirin... Contraindicated / Not Indicated... Inotropics... Beta Blockers... Contraindicated / Not Indicated... Steroids... Contraindicated / Not Indicated... Nitrates IV... ACE Inhibitors... Contraindicated / Not Indicated... Anticoagulants... Coumadin... For v.73 data, the Contraindicated/Not Indicated option was deleted AV Replace -- 60

61 Isolated Aortic Valve Replacement Procedures Like Group STS Lipid-Lowering agents... Contraindicated / Not Indicated... Glycoprotein IIb/IIIa Inhibitor... ADP Inhibitors within 5 Days... Contraindicated / Not Indicated... ADP Inhibitor Discontinuation < Day... Day... Days... 3 Days... 4 Days... 5 Days... Antiplatelets within 5 Days... Contraindicated / Not Indicated... Operative Information Blood Products Used... Number of Blood Product Units Used Red Blood Cell Unit... Red Blood Cell Units... 3 Red Blood Cell Units Red Blood Cell Units... + Fresh Frozen Plasma Units... + Cryoprecipitate Units... + Platelet Units... For v.73 data, the Contraindicated/Not Indicated option was deleted Excludes patients not on ADP Inhibitors within 5 Days AV Replace -- 6

62 Isolated Aortic Valve Replacement Procedures Like Group STS IABP... Preop... Intraop... Postop... Missing timing... Robotic Technology Assisted... Cross-Clamp Time (min) Mean... Median... 5 th Percentile th Percentile... Cardiopulmonary Bypass Time (min) Mean... Median... 5 th Percentile th Percentile... Circulatory Arrest... Circulatory Arrest Time (min) Mean... Median... 5 th Percentile th Percentile... Skin Incision Duration (min) Mean... Median... 5 th Percentile th Percentile... AV Replace -- 6

63 Isolated Aortic Valve Replacement Procedures Like Group STS OR Duration (min) Mean... Median... 5 th Percentile th Percentile... Valve Surgery Aortic Annular Enlargement... Valve Replacement Type Mechanical... Bioprosthetic... Homograft... Autograft... Antibiotic Selection,... Exclusions... Antibiotic Timing, 3... Exclusions... Antibiotics Discontinued, 4... Exclusions... Postoperative Information Blood Products Used... Number of Blood Product Units Used Red Blood Cell Unit... Red Blood Cell Units... 3 Red Blood Cell Units Red Blood Cell Units... + Fresh Frozen Plasma Units... + Cryoprecipitate Units... + Platelet Units... All antibiotic measures are calculated among patients without exclusions First or second generation cephalosporin prescribed/given prophylactically 3 Appropriate timing of prophylactic antibiotics 4 Prophylactic antibiotics discontinued within 48 hours AV Replace -- 63

64 Isolated Aortic Valve Replacement Procedures Like Group STS Intraop/Postop Blood Products Used... Total Number of Blood Product Units Red Blood Cell Unit... Red Blood Cell Units... 3 Red Blood Cell Units Red Blood Cell Units... + Fresh Frozen Plasma Units... + Cryoprecipitate Units... + Platelet Units... Ventilation Total Ventilation Hours Mean... Median... 5 th Percentile th Percentile... Initial Ventilation Hours Mean... Median... Initial Ventilation <6 hours... Extubated in OR... Reintubation... Additional Ventilation Hours Mean... Median... ICU Stay Total ICU Hours Mean... Median... 5 th Percentile th Percentile... Excludes patients extubated in the OR Among patients reintubated AV Replace -- 64

65 Isolated Aortic Valve Replacement Procedures Like Group STS Initial ICU Hours Mean... Median... Readmitted to ICU... Additional ICU Hours Mean... Median... Mortality Summary In-hospital Mortality... Operative Mortality... Mortality Risk-Adjustment In-hospital Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Operative Mortality Odds Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... O/E Ratio... Lower 95% Confidence Limit... Upper 95% Confidence Limit... Risk-adjusted Rate... Among patients readmitted to the ICU Refer to the Report Overview for information on risk-adjustment methodology Risk-adjustment is not performed on time periods of less than 6 months AV Replace -- 65

66 Isolated Aortic Valve Replacement Procedures Like Group STS Complications Summary Any Complications... Any Major Complications / Operative Mortality... Operative Complications Any Reoperation... Reoperation for Bleeding... Reoperation for Valvular Dysfunction... Reoperation for Graft Occlusion... Reoperation for Other Cardiac... Reoperation for Other Non-Cardiac... Infection Complications Any Infection... Deep Sternal Infection/Mediastinitis... Septicemia/Sepsis... Neurological Complications Any Neurological... Coma/Encephalopathy... Permanent Stroke... Transient Ischemic Attack... Paralysis... Pulmonary Complications Any Pulmonary... Prolonged Ventilation... Pneumonia... Pulmonary Embolism... Pleural Effusion Requiring Drainage... Renal Complications Renal Failure... Vascular Complications Any Vascular... Acute Limb Ischemia... Includes surgical and PCI/Transcatheter interventions Excludes patients with preoperative dialysis or last creatinine >=4 AV Replace -- 66

67 Isolated Aortic Valve Replacement Procedures Like Group STS Other Complications Any Other... New Onset Atrial Fibrillation... Recurrent Recent Atrial Fibrillation... Cardiac Arrest... Anticoagulant Complication... Tamponade... Gastro-Intestinal Complication... Multi-System Failure... Discharge Location 3 Home... Extended Care/TCU... Other Acute Care Hospital... Nursing Home... Hospice... Left AMA 4... Other... Discharge Medications 3 Aspirin... Contraindicated / Not Indicated... ACE Inhibitors... Contraindicated / Not Indicated... Beta Blockers... Contraindicated / Not Indicated... New Onset AFib is only among patients with no history of arrhythmias Recent Recurrent AFib is among patients with history of recent Afib 3 Excludes in-hospital mortalities 4 Option added in v.8 AV Replace -- 67

68 Isolated Aortic Valve Replacement Procedures Like Group STS Any Lipid-Lowering Agents... Contraindicated / Not Indicated... Statin Lipid-Lowering Agents... Contraindicated / Not Indicated... Non-Statin Lipid-Lowering Agents... Contraindicated / Not Indicated... ADP Inhibitors... Contraindicated / Not Indicated 3... PY Antagonists... Contraindicated / Not Indicated... Other Antiplatelets... Contraindicated / Not Indicated... Antiarrhythmics... Contraindicated / Not Indicated 3... Amiodarone... Contraindicated / Not Indicated... Variable dropped in v.8 Variable added in v.8 AV Replace -- 68

69 Isolated Aortic Valve Replacement Procedures Like Group STS Coumadin... Contraindicated / Not Indicated... Discharge Referrals/Counseling Cardiac Rehabilitation Referral... Smoking Cessation Counseling... Readmission and Reason 3 Readmitted within 30 days 4... Anticoagulation Complication Valvular... Pharmacological... Arryhthmia/Heart Block... Congestive Heart Failure... MI and/or Recurrent Angina... Pericardial Effusion / Tamponade... Pneumonia or other Respiratory Complication 5... Pneumonia 6... Respiratory Complications, Other 6... Pleural Effusion req. Intervention 6... Coronary Artery Dysfunction... Valve Dysfunction... Infection - Deep Sternum... Infection - Conduit Harvest Site... Renal failure... TIA / Permanent CVA... Acute Vascular Complication... Subacute Endocarditis... VAD Complication... Other... Other - Planned readmission 6... Missing/Unknown... AV Replace For v.73 data, the Contraindicated/Not Indicated option was deleted Excludes in-hospital mortalities and Not Applicable Records 3 Excludes in-hospital mortalities 4 Timed from procedure for v.73, from discharge for v.8 5 Option dropped in v.8 6 Option added in v.8

70 Isolated Aortic Valve Replacement Procedures Like Group STS Length of Stay Summary Total Length of Stay (days) Mean... Median... 5 th Percentile th Percentile... Post-Procedure Length of Stay (days) Mean... Median... 5 th Percentile th Percentile... PLOS <6 days... PLOS >4 days... AV Replace -- 70