Heart surgery programs innovation using surgical risk stratification at the São Paulo State Public Healthcare System: SP-SCORE-SUS STUDY

Mejía, Omar Asdrúbal Vilca; Lisboa, Luiz Augusto Ferreira; Dallan, Luís Alberto Oliveira; Pomerantzeff, Pablo Maria Alberto; Trindade, Evelinda; Jatene, Fábio Biscegli; Filho, Roberto Kalil

doi:10.5935/1678-9741.20130037

Cited by 11 publications

(12 citation statements)

References 32 publications

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“…5 Com o tempo, o InCor assumiu a liderança ao estabelecer uma parceria com a Secretaria do Estado da Saúde de São Paulo para a construção do Registro Paulista de Cirurgias Cardiovasculares: o REPLICCAR. 6…”

Section: Introductionunclassified

Análise de >100.000 Cirurgias Cardiovasculares Realizadas no Instituto do Coração e a Nova Era com Foco nos Resultados

et al. 2020

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ResumoFundamento: O desafio atual da cirurgia cardiovascular (CCV) é melhorar resultados em pacientes cada vez mais graves. Nesse sentido, Programas de Melhoria Contínua da Qualidade (PMCQ) tem impactado os resultados. Objetivo: Avaliar a evolução da incidência e mortalidade das CCV, assim como os resultados atuais do Instituto do A análise incluiu o total de cirurgias e a evolução dos procedimentos mais frequentes.Resultados: Foram realizadas 105.599 CCV, com uma média anual de 2.964 procedimentos e mortalidade de 5,63%. Comparando o 4° com o 5° período, o volume global médio de cirurgias foi de 2.943 para 3.139 (p = 0,368), cirurgias de revascularização miocárdica (CRM) de 638 para 597 (p = 0,214), valvas cardíacas de 372 para 465 (p = 0,201) e cardiopatias congênitas de 530 para 615 (p = 0,125). A mortalidade média global passou de 7,8% para 5% (p < 0,0001), nas cirurgias de revascularização miocárdica de 5,8% para 3,1% (p < 0,0001), nas cirurgias valvares de 14% para 7,5% (p < 0,0001) e nas cirurgias de cardiopatias congênitas de 12,1% para 9,6% (p < 0,0001). Conclusão: Embora haja uma tendência recente ao aumento dos volumes cirúrgicos, houve uma diminuição significativa da mortalidade cirúrgica nos grupos analisados. Após o estabelecimento do PMCQ, as taxas de mortalidade se aproximaram a dos padrões internacionais. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0) Palavras-chave: Procedimentos Cirúrgicos Cardiovasculares/tendências; Melhoria de Qualidade; Segurança do Paciente; Mortalidade Hospitalar; Banco de Dados. AbstractBackground: The current challenge of cardiovascular surgery (CVS) is to improve the outcomes in increasingly severe patients. In this respect, continuous quality improvement (CQI) programs have had an impact on outcomes.Objective: To assess the evolution of the incidence and mortality due to CVS, as well as the current outcomes of the Hospital das Clínicas Heart ). The CQI program was implemented between 2015 and 2016. The analysis included the total number of surgeries and the evolution of the most frequent procedures.Results: A total of 105,599 CCVs were performed, with an annual mean of 2,964 procedures and mortality of 5,63%. When comparing the 4th and the 5th periods, the average global volume of surgeries was increased from 2,943 to 3,139 (p = 0.368), bypass graft (CABG), from 638 to 597 (p = 0.214), heart valve surgery, from 372 to 465 (p = 0.201), and congenital heart disease surgery, from 530 to 615 (p = 0.125). The average global mortality went from 7.8% to 5% (p < 0.0001); in CABG surgery, from 5.8% to 3.1% (p < 0.0001); in heart valve surgery, from 14% to 7.5% (p < 0.0001) and in congenital heart disease surgery, from 12.1% to 9.6% (p < 0.0001). Conclusion:In spite of a recent trend towards increased surgical volume, there was a significant decrease in operative mortality in the groups studied. After the implementation of the CQI program, the mortality rates were closer to international standards. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

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Section: Introductionunclassified

Análise de >100.000 Cirurgias Cardiovasculares Realizadas no Instituto do Coração e a Nova Era com Foco nos Resultados

et al. 2020

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“…Cardiac surgery is widely used to treat those diseases [2] . It is indicated to provide better quality of life to the patients.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, development and validation of local models are becoming increasingly necessary due to demographic, socioeconomic, and cultural aspects of different populations [4,5] . The combination of the data resulting from the risk score models allows for adaptation, improvement and even innovation in treatment programs [2] .…”

Section: Introductionmentioning

confidence: 99%

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Mortality Risk After Cardiac Surgery: Application of Inscor in a University Hospital in Brazil's Northeast

Fortes¹,

Silva²,

Baldez³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveTo apply the InsCor in patients undergoing cardiac surgery in a university hospital in Brazil's northeast.MethodsIt is a retrospective, quantitative and analytical study, carried out at the University Hospital of the Federal University of Maranhão. InsCor is a remodeling of two risk score models. It evaluates the prediction of mortality through variables such as gender, age, type of surgery or reoperation, exams, and preoperative events. Data from January to December 2015 were collected, using a Physical Therapy Evaluation Form and medical records. Quantitative variables were expressed as mean and standard deviation and qualitative variables as absolute and relative frequencies. Fisher's exact and Kruskal-Wallis tests were applied, considering significant differences when P value was < 0.05. Calibration was performed by Hosmer-Lemeshow test.ResultsOne hundred and forty-eight patients were included. Thirty-six percent were female, with mean age of 54.7±15.8 years and mean body mass index (BMI) equal to 25.6 kg/m2. The most frequent surgery was coronary artery bypass grafting (51.3%). According to InsCor, 73.6% of the patients had low risk, 20.3% medium risk, and only 6.1% high risk. In this sample, 11 (7.4%) patients died. The percentage of death in patients classified as low, medium and high risk was 6.3, 7.1% and 11.1%, respectively.ConclusionInsCor presented easy applicability due to the reduced number of variables analyzed and it showed satisfactory prediction of mortality in this sample of cardiac surgery patients.

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“…In parallel, the evaluation of the characteristics and outcomes of interventional procedures such as the use of stents in the treatment of heart failure 6 and cardiac surgeries in the treatment of valvular heart diseases or heart failure 7 have also been the subject of specific records.…”

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confidence: 99%

Implementation of Multicenter Records in the Therapeutic Cardiovascular Assessment in Brazil

Moreira¹

2013

Arquivos Brasileiros De Cardiologia

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Heart surgery programs innovation using surgical risk stratification at the São Paulo State Public Healthcare System: SP-SCORE-SUS STUDY

Abstract: 264Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(2):263-9 Rev

Cited by 11 publications

References 32 publications

Análise de >100.000 Cirurgias Cardiovasculares Realizadas no Instituto do Coração e a Nova Era com Foco nos Resultados

Análise de >100.000 Cirurgias Cardiovasculares Realizadas no Instituto do Coração e a Nova Era com Foco nos Resultados

Mortality Risk After Cardiac Surgery: Application of Inscor in a University Hospital in Brazil's Northeast

Implementation of Multicenter Records in the Therapeutic Cardiovascular Assessment in Brazil

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