Development and results of Puglia adult cardiac surgery registry
Domenico Paparella1, Pietro Guida, Lucia Bisceglia
1aDivision of Cardiac Surgery, Department of Emergency and Organ Transplant, University of Bari Aldo Moro bPuglia Health Regional Agency cDepartment of Cardiac Surgery, Villa Bianca Hospital dDepartment of Cardiac Surgery, Santa Maria Hospital, Bari eDepartment of Cardiac Surgery, Villa Verde Hospital, Taranto fDepartment of Cardiac Surgery, Città di Lecce Hospital gDepartment of Cardiac Surgery, Vito Fazzi Hospital, Lecce hDepartment of Cardiac Surgery, Anthea Hospital iDivision of Anesthesia, Department of Emergency and Organ Transplant, University of Bari Aldo Moro, Bari, Italy.
Aims:
To evaluate the feasibility of a cardiac surgery registry and to describe patients' characteristics, type of procedures performed, incidence of postoperative complications with short and middle-term mortality.
Methods:
A database with clinical information and details on cardiac surgical operations was implemented by Puglia Health Regional Agency to collect data of each cardiac surgery procedure performed in the seven adult cardiac surgery centres of the region. Health regional agency personnel guaranteed data accuracy and quality control procedures. Mortality after the discharge was evaluated for residents in Puglia by linking clinical data to the Health Information System.
Results:
From January 2011 to December 2012, 6429 operations were performed. All operations were included in the registry with very high completeness of collected data (95.3% per patient). The majority of the operations performed were coronary artery bypass graft alone (41.1%), valve surgery alone (26.2%), coronary artery bypass graft and valve surgery (11.4%), or valve with other surgery (11.8%). During a median follow-up of 12 months (interquartile range 6-18 months), 211 deaths were detected after the discharge. Overall, cumulative mortality from the operation was 8.2% at 6 months and 9.5% at 12 months.
Conclusion:
Implementation of a regional clinical registry of cardiac surgery is feasible with a great level of accuracy and the evaluation of mid-term mortality overcomes the limited value of hospital mortality. An accurate cardiac surgery registry elicits epidemiologic evaluations, comparisons between expected and observed mortality, incidence of postoperative complications and encourages a reliable public reporting.
