2013 Clinical Results


Sacramento Cardiovascular Surgeons continue to perform well ahead of clinical peers and national benchmarks according to the 2013 Society of Thoracic Surgeons’ published results. SacCardio continues to achieve excellence for the surgical treatment of cardiac disease by staying focused on the net result – patient outcomes. This focus has resulted in superior results for overall mortality, complications, and blood usage across the most comprehensive treatment options in the area.

In addition to coronary artery bypass grafts (CABG) and valve procedures, SacCardio and Sutter Medical Center are a nationally recognized provider for the surgical treatment of atrial fibrillation, becoming the second cardiac care center in the nation and the first in California to receive full Atrial Fibrillation Certification status from the Society of Chest Pain Centers (SCPC.)

SacCardio provides both ventricular assist device (VAD) and heart transplantation procedures. SacCardio and Sutter Medical Center became the first in the nation to receive the Joint Commission’s “Advanced Certification in Heart Failure – Gold Status” recognition by meeting the American Heart Association’s (AHA’s) “Get with the Guidelines – Heart Failure.”

 

OVERALL RISK-ADJUSTED MORTALITY

SacCardio’s overall risk-adjusted mortality continues to exceed the like and national averages, despite an increase in case complexity and co-morbidities, with an overall rate of 1.1 percent in 2013. SacCardio is one of the larger programs in California with 533 primary procedures and 794 total cardiac procedures performed in 2013.

OVERALL RISK-ADJUSTED MORTALITY

Overall risk-adjusted mortality is the most common single indicator measuring surgical results. These weighted averages must be risk-adjusted to patient population due to varied case complexity across institutions.

 

RISK ADJUSTED IN-HOSPITAL MORTALITY

SacCardio achieved better results than Like and STS National groups for overall risk adjusted in-hospital mortality and within each major group. In 2013, the chance of patient death for SacCardio was 39 percent less for all procedures than Like groups at only 1.1 percent. For Isolated CABG procedures, SacCardio had an overall risk-adjusted mortality rate of only .6 percent; less than half of  Like Groups at 1.4 percent.  For some procedures, it was zero.

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RISK ADJUSTED IN-HOSPITAL MORTALITY

Procedures have varied risk structures based on overall complexity and co-morbidities.

 

MAJOR COMPLICATIONS / OPERATIVE MORTALITY

Compared to Like groups and STS National averages, SacCardio achieved 21 percent reduction in major complications and operative mortality. For Isolated CABG cases, the most common procedure performed, SacCardio achieved greater than 35 percent reduction in major complications and operative mortality.

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MAJOR COMPLICATIONS / OPERATIVE MORTALITY

Cardiac procedures have varied risk structures based on overall complexity and co-morbidities. Risk-adjusted data is only available for Isolated CAB procedures with SacCardio (7.6 percent) similarly outperforming Like group (11.8 percent), and National (13.0 percent) benchmarks.

 

CROSS CLAMP TIME (minutes)

SacCardio’s experienced team of surgeons have significantly shorter cross clamp durations than Like groups and STS National averages across all surgical procedures. For Isolated CABGs, the most common procedure, SacCardio is 22.2 minutes faster than Like groups, reducing the cross clamp time by more than 34 percent.

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CROSS CLAMP TIME

Cross clamp time is the duration to clamp off systemic circulation and blood flow through the heart. Longer cross clamp times have been shown to adversely affect patient outcomes.

 

CARDIOPULMONARY BYPASS TIME (minutes)

SacCardio’s team of experienced surgeons have shorter cardiopulmonary bypass time durations across all surgical procedures with over 28 percent less time required. For Isolated CABG procedures, this duration is more than twenty-seven minutes less than Like groups and STS National averages, nearly a third less the duration time for a patient to require support of the heart lung machine.

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CARDIOPULMONARY BYPASS TIME

Cardiopulmonary bypass time is the length of time for a patient to receive mechanical pumping and oxygenation support from an external heart lung machine. This process exposes the patient’s blood to artificial surfaces which may lead to an inflammatory response. Longer cardiopulmonary bypass times have been shown to adversely affect patient outcomes.

 

BLOOD PRODUCTS USED (ANY INTRA/POST-OP)

SacCardio has an integrated team approach to reduce the need for blood products utilizing advanced techniques and technology. This technique consistently leads to a lower use of blood products than both Like groups and STS National averages. For Isolated CABG procedures, SacCardio surgeries use at least 12.9 percent less blood products than Like groups and 15.9 percent less than National groups.

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Overview Detail

BLOOD PRODUCTS USED (ANY INTRA/POST-OP)

Blood products can be life saving and are often required to treat a patient condition. However, they are an imperfect substitute for a patient’s own blood and may lead to an increased risk of morbidity and mortality. Blood products include packed red cells, fresh frozen plasma, cryoprecipitate and/or platelets.

 

 

Like Group – The like group is a comparison group of STS participants that are most similar.

STS – The STS Adult Cardiac Surgery Database currently gathers information from more than 90 percent of the roughly 1,100 surgical groups in the United States that perform cardiac surgery.