Alert

Cardiothoracic Surgical Survival Rates by STAT Category of Complexity

Background and The Society for Thoracic Surgeons Database

Each year in the United States, congenital heart surgeons perform more than 200 different types of procedures on fewer than 1 million patients. To evaluate surgical procedures based on complexity, The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STS) categorizes congenital cardiothoracic operations into one of five “STAT” categories. Level 1 is the least complex, while Level 5 procedures are the most complex.  Available data is only one metric by which the quality of a program should be assessed.  Multiple factors, not measured by STS, make comparing survival outcomes exceedingly challenging.

UNC has been a reporting member to the STS Congenital Heart Surgery database from early after its inception.  For many years, we have used this data as part of our broader continuous performance improvement efforts and to contribute data for aggregation to allow for better understanding risks for rare diagnoses or procedures. . In an effort to offer further transparency into our program, we are now publishing our cardiac surgery data. UNC Medical Center is making its data public for those periods where there was more than one provider due to peer review protection issues.

One important fact to understand is that the STAT categories are imperfect and do not uniformly account for how sick a child is. For instance, a premature newborn with multiple risk factors may need a lower STAT-category procedure, but the child’s risk is still higher due to his/her underlying conditions. Furthermore, outcomes data does not capture several risk factors that disproportionately impact our patient population as North Carolina’s safety net hospital. No data can account for all significant variables which contribute to outcomes and are not reflected in the database.  

At UNC Children’s, we pride ourselves on taking highly complex patients, some of whom have been declined by other centers and have nowhere else to go. We strive to save every child and to stand by families through very challenging circumstances.  We are committed to continuous quality improvement as a cornerstone of our program and care. We delight in the many children whose lives we save and return to see us each year at a celebration in their honor.

Our surgeons at UNC Children's have been successfully performing such surgeries and caring for these children for decades- always with an eye toward providing the best care possible for our patients. Our families get comprehensive, compassionate, family-centered care from UNC Children's board-certified specialists.

Cardiothoracic Surgical Survival Rates by STAT Category of Complexity

(STAT Category 1-5: Level 1, least complex; Level 5, most complex)


Congenital Heart Surgery Data Summary

Risk-Stratified Mortality Data

(Neonates + Infants + Children + Adults)

 July '13- June '14  July '14- June '15  July '15- June '16 July '16- June '17
          Surgeries   Deaths   Surgeries   Deaths   Surgeries   Deaths   Surgeries    Deaths 
STAT Level 1  34 0 40 0 31 1 30 0

STAT Level 2

50 1 42 0 47 0 39 1

STAT Level 3

18 1 22 2 34 2 20 1
STAT Level 4 27 2 25 5 21 1 20 3
STAT Level 5 9 2 2 1 3 1 1 0
Total 138 6 131 8 136 5 110 5



Most Recent Results (partial year)

 

July ’18- Mar ‘19

Surgeries

Deaths

STAT level 1

31

0

STAT level 2

27

0

STAT level 3

7

0

STAT level 4

15

2

STAT level 5

2

0

Total

82

2

Congenital Heart Surgery Data Summary

Risk-Stratified Mortality Data

Aggregate data from last 4 years (July 2013 – June 2017)

(Neonates + Infants + Children + Adults)

STAT Mortality Categories were developed by the Society for Thoracic Surgeons as a means of distinguishing the range of complexities for pediatric congenital heart surgery. Operations were sorted by increasing risk and grouped into 5 levels (the STAT Mortality Levels). STAT Level 1 is the least complex surgeries, and STAT Level 5 is the most complex. The STAT Mortality levels allow outcomes to be assessed in relation to the complexity of the operations being performed, but they do not include all risk factors that disproportionately impact our patient population as North Carolina’s safety net hospital.  Levels also lump together many different specific procedures.  

Total Cases Deaths
STAT Level 1 135 1
STAT Level 2 178 2
STAT Level 3 94 6
STAT Level 4 93 11
STAT Level 5 15 4

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