Alert

Explanation of Star Ratings

The Society of Thoracic Surgeons (STS) provides detailed explanations of its methodology for star ratings on its website, along with publicly reported information from participating hospitals.

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. 

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
Mortality Data

(Neonates + Infants + Children + Adults)

  July '13–June '14 July '14–June '15 July '15–June '16 July '16–June '17 July '17–June '18
Surgeries Deaths Surgeries Deaths Surgeries Deaths Surgeries Deaths Surgeries Deaths
STAT Level 1 34 0 40 0 31 1 30 0 31 0
STAT Level 2 50 1 42 0 47 0 39 1 24 1
STAT Level 3 18 1 22 2 34 2 20 1 10 0
STAT Level 4 27 2 25 5 21 1 21 4 19 1
STAT Level 5 9 2 2 1 3 1 2 0 6 4
Total 138 6 131 8 136 5 112 6 90 6

On mobile, scroll to view full table.

Most Recent Results

  July '18–June '19
Surgeries Deaths
STAT level 1 42 0
STAT level 2 36 0
STAT level 3 10 0
STAT level 4 17 3
STAT level 5 2 0
Total 107 3

On mobile, scroll to view full table.

STS Congenital Heart Surgery Data Summary

Risk Adjusted Mortality and Star Rating

STS Period ending 12/31/2018

Model 1 - Participant Operative Mortality, Adjusted Operative Mortality and Star Rating, Last 4 Years (Jan 2015 - Dec 2018)^

Neonates

  #/Eligible Observed Expected Observed/Expected (95% CI) AMR^^ (95% (CI) STS
All STAT Mortality Categories 15/ 84 17.9% 7.6% 2.36 (1.37 , 3.67) 19.0 (11.0 , 29.6) 8.1%
STAT level 1 0/ 3 0.0% 1.1% 0.0 (0.00 , 65.86) 0.0 (0.0 , 100.00) 2.4%
STAT level 2 1/ 16 6.3% 2.5% 2.47 (0.06 , 11.97) 9.0 (0.2 , 43.7) 3.7%
STAT level 3 1/ 9 11.1% 2.4% 4.56 (0.12 , 19.79) 13.1 (0.3 , 56.7) 2.9%
STAT level 4 6/ 44 13.6% 8.2%

1.66 (0.63 , 3.32)

13.9 (5.3 , 27.8) 8.4%
STAT Level 5 7/ 12 58.3% 17.3% 3.38 (1.60 , 4.92) 51.8 (24.6 , 75.3) 15.3%

On mobile, scroll to view full table.

Neonates + Infants

  #/Eligible Observed Expected Observed/Expected (95% CI) AMR^^ (95% (CI) STS
All STAT Mortality Categories 23/ 212 10.8% 5.0% 2.19 (1.41 , 3.20) 10.1 (6.5 , 14.7) 4.6%
STAT level 1 1/ 52 1.9% 0.6% 3.20 (0.08 , 17.06) 2.3 (0.1 , 12.3) 0.7%
STAT level 2 1/ 53 1.9% 2.4% 0.77 (0.02 , 4.13) 2.0 (0.0 , 10.5) 2.5%
STAT level 3 3/ 28 10.7% 3.0% 3.61 (0.76 , 9.50) 9.7 (2.1 , 25.7) 2.7%
STAT level 4 11/ 67 16.4% 8.9%

1.83 (0.95 , 3.07)

14.0  (7.2 , 23.4) 7.6%
STAT Level 5 7/ 12 58.3% 17.3% 3.38 (1.60 , 4.92) 48.9 (23.2 , 71.1) 14.5%

On mobile, scroll to view full table.

Neonates + Infants + Children

  #/Eligible Observed Expected Observed/Expected (95% CI) AMR^^ (95% (CI) STS
All STAT Mortality Categories 25/ 393 6.4% 3.0% 2.11 (1.38 , 3.07) 6.3 (4.1 , 9.2) 3.0%
STAT level 1 1/ 94 1.1% 0.4% 2.59 (0.07 , 14.10) 1.0 (0.0 , 5.5) 0.4%
STAT level 2 2/ 136 1.5% 1.4% 1.05 (0.13 , 3.71) 1.7 (0.2 , 6.0) 1.6%
STAT level 3 4/ 70 5.7% 1.6% 3.46 (0.96 , 8.48) 7.3 (2.0 , 18.0) 2.1%
STAT level 4 11/ 81 13.6% 7.8%

1.74 (0.89 , 2.94)

11.4 (5.9 , 19.3) 6.6%
STAT Level 5 7/ 12 58.3% 17.3% 3.38 (1.60 , 4.92) 47.6 (22.6 , 69.2) 14.1%

On mobile, scroll to view full table.

Neonates + Infants + Children + Adults

  #/Eligible Observed Expected Observed/Expected (95% CI) AMR^^ (95% (CI) STS
All STAT Mortality Categories 25/ 461 5.4% 2.7% 2.00 (1.30 , 2.91) 5.6 (3.7 , 8.2) 2.8%
STAT level 1 1/ 124 0.8% 0.4% 2.16 (0.05 , 11.80) 0.8 (0.0 , 4.6) 0.4%
STAT level 2 2/ 153 1.3% 1.3% 0.99 (0.12 , 3.50) 1.5 (0.2 , 5.4) 1.5%
STAT level 3 4/ 85 4.7% 1.6% 2.85 (0.79 , 7.04) 6.1 (1.7 , 14.9) 2.1%
STAT level 4 11/ 87 12.6% 7.5%

1.68 (0.86 , 2.85)

10.7 (5.5 , 18.2) 6.4%
STAT Level 5 7/ 12 58.3% 17.3% 3.38 (1.60 , 4.92) 47.4 (22.5 , 69.0) 14.0%

On mobile, scroll to view full table.

Overall Star Rating: One Star^^^

^Includes only patients eligible for adjustment. See report interpretation guide for information on adjustment methodology.

^^Adjusted Mortality Rate (AMR)

^^^The star rating is based on the overall observed-to-expected ratio for operative mortality. Population includes all eligible patients as described in the report interpretation guide.

Top