Database

The trusted data in the STS National Database™ has been a cornerstone for scientific research and quality improvement for more than three decades—and recently its General Thoracic (GTSD) and Congenital Heart (CHSD) surgery databases made major leaps toward demonstrating their importance across the United States.  GTSD Participants Can Earn Credit for Transparency US News & World Report recently announced its decision to create a new Public Transparency measure to be used in its Best Hospitals rankings in Pulmonology & Lung Surgery. The measure will be based on whether a hospital elects to publicly report its lobectomy outcomes on the GTSD public reporting website as of February 12, 2023.   “This is a boon for high-performing hospitals who participate in the GTSD,” said Vinay Badhwar, MD, chair of the STS Council on Quality, Research, and Patient Safety. “Those who already are publicly reporting their outcomes to the Database now have the option to earn Transparency best rankings, and GTSD participants who were not publicly reporting were given the means to opt in last month.” Dr. Badhwar added, “For hospitals who are not GTSD participants, the time to join is now.” The next edition of Best Hospitals will feature the new Public Transparency measure, and the measure will have a weight of 3% in the adult Pulmonology & Lung Surgery specialty rankings. “The same measure will be included in the Procedures & Conditions statistical analysis, and it likely will be used in calculating the Lung Cancer Surgery ratings,” wrote US News’ Ben Harder.  This means that, by simply enrolling in the STS National Database Public Reporting initiative, hospitals can receive the transparency credit.  More than 100 thoracic surgery programs nationwide are already publicly reporting their surgical outcomes. US News will review the GTSD public reporting site in February 2023, and they release their Best Hospitals lists once a year.  If a hospital joins GTSD in 2023 and enrolls in public reporting, they will be eligible to receive the transparency credit in 2024.  "For hospitals who are not GTSD participants, the time to join is now." Vinay Badhwar, MD CHSD Makes History with Infant Surgical Trial In a first-of-its-kind multicenter, NIH-funded randomized trial within a registry, investigators have found that infants undergoing cardiopulmonary bypass surgery experienced no difference in outcomes when they received prophylactic glucocorticoids versus placebo. Results from the study, made possible by the CHSD and 24 participating sites, appeared last month in the New England Journal of Medicine.  “With an NIH award of over 5 million dollars, our team successfully conducted a multicenter, prospective, randomized, placebo-controlled, registry-based clinical trial with participants enrolled at 24 sites participating in the CHSD,” said Jeffrey P. Jacobs, MD, principal investigator for the grant, titled “Leveraging existing registry resources to facilitate clinical trials.” With data curated in the CHSD, researchers were able to randomize outcomes for 1,200 infants and newborns undergoing open-heart surgery. Glucocorticoids have been used for decades in this surgical population, but until now, their benefits have remained unconfirmed. With this CHSD analysis, the research team assessed a primary outcome composite of operative mortality, 13 individual major complications, and postoperative length of stay.  “Among infants undergoing surgery with cardiopulmonary bypass, prophylactic methylprednisolone did not significantly decrease the likelihood of a worse outcome in adjusted analysis,” the authors wrote, noting that methylprednisolone additionally was associated with increased postoperative hyperglycemia requiring insulin.  The publication of these results is a reflection of the quality and power of the Database, said Dr. Jacobs, who served on STS’s Workforce on National Databases and as chair of its Congenital Heart Surgery Database Task Force. Based on his experiences, he emphasized, “The STS Congenital Heart Surgery Database is the premier registry in the world for pediatric quality assessment and research.” Database Makes Never-Before-Seen Science Possible at STS 2023 At the upcoming STS Annual Meeting in San Diego, presenters will unveil novel scientific discoveries gleaned from the robust data curation in the STS Adult Cardiac, Congenital, General Thoracic, and Intermacs/Pedimacs Databases, including Frozen elephant trunk versus traditional limited repair in acute type 1 aortic dissection Variables affecting survival in pediatric patients supported with ventricular assist devices Targeted molecular therapy and immunotherapy for lung and esophageal cancer Postcardiotomy shock and 30-day outcomes in patients with severe left ventricular systolic dysfunction Survival outcomes for patients undergoing lung transplant Establishment of an STS adult congenital heart surgery risk model The impact of surgical strategy on isolated tricuspid valve outcomes Practice patterns in the management of tetralogy of Fallot

John H. Calhoon, MD STS News, Fall 2022 — It’s hard to believe my year as President is already complete. There were several memorable moments, including Coronary Congress in early summer in Ottawa, Ontario, Canada, followed by resident Boot Camp, AQO, and a great EACTS meeting in Milan, Italy. In early December, STS/EACTS and LACES put on an excellent cardiac meeting in Cartagena, Columbia, attended by more than 300 Latin American surgeons and other participants. This year’s meetings generated a lot of value for surgeons, residents, students, and industry partners enjoying the opportunity to be back together in person.  This past year, STS has been investigating ways to broaden its reach and impact internationally. To this end, we have proposed bylaws changes—to be reviewed at the STS Business Meeting at STS 2023—that will promote equal standing for members across the world. STS 2023 is really shaping up. Early atten­dance figures look as good as ever, but what is most energizing is the program. Dr. Adil Husain, Ms. Michele Rush, and their team have put together a great meeting. It is designed to give attendees some time during the day to go for a walk or grab lunch with a spouse, friend, or colleague—to not just talk about work/life balance, but to actually live it a bit.  Themes for this year’s meeting include: • Education, not just of our students and residents, but of ourselves.  • Social unrest: avoiding noise while navigating equitably and inclusively. • Data and how we should be using it. To this end, we have three great invited speakers lined up.  One is Dr. Francisco Cigarroa, one of my surgical colleagues in San Antonio. He previously dabbled in administration as president of our medical school, and then as chancellor of the entire UT system, before going back to just being a very talented and hardworking director of organ transplant programs. He will be delivering the Vivien Thomas Lecture to open our annual meeting. Please make every effort to be there Saturday morning as it promises to be awesome.  Our Thomas Ferguson Lecturer is a great orator, the Rev. Max Lucado, who will be speaking about “recalling our calling.” I’ve come to know Max well and I respect him tremendously. This talk will resonate with everyone about why we went into medicine and surgery and how to continue to enjoy the many great parts of our profession. It will not be evangelical, just something good for our souls.  Finally, we can all be really excited about Dr. Peter Smith agreeing to deliver the C. Walton Lillehei Lecture. He is going to be speaking about how CABG still is, in many cases, the best possible treatment for coronary disease. There is likely no one who has used data better than Dr. Smith to highlight our worth to patients, institutions, and to the health care industry. He almost singlehandedly helped us prevail with RVU based reimbursement over a decade ago. His talk on “the collision of a belief system with the evidence” will no doubt highlight just that.  Dr. Jo Chikwe and her team at The Annals continue to help us strengthen knowledge and skills as a key part of the STS experience. The STS Research Center and STS National Database have made progress this year in achieving quality and consistency of data to assess and benchmark performance. STS research and analytics services are increasingly used by physicians, researchers, payers, pharma, and industry for quality improvement initiatives, comparative effectiveness research, post-market surveillance, clinical trials, and basic and translational research. In addition, US News & World Report, starting in 2023, will track STS lobectomy outcomes through the GTSD—generating a lot of interest from hospitals! Learn more on page 7.  One thing which has been sad for so many of us was the sudden loss of Dr. Sean Grondin. As stated before, Sean was simply a wonderful man, surgeon, husband, father, son, teacher, and leader. His loss so soon was hard to fathom and remains simply hard to even process. His knack of spending time where it mattered and finding the right “fit” for whatever the situation is even more poignant now.  So, hope all enjoyed a wonderful holiday season and are looking forward to an even better 2023.  God Bless,  John