Cardiac

The aim of the Society of Cardiothoracic Surgeons National Adult Cardiac Surgery Database is to improve quality of care for cardiac patients by allowing appropriate comparison of clinical performance with national and international standards, and to provide useful data on changing trends within the speciality. We have been actively collecting, analysing and benchmarking data since as early as 1977, and we are widely recognised as international leaders in the field, having published data down to individual surgeon level since 2005.

Our current programme consists of the following

1. Systematic collection of an agreed minimum dataset at each contributing centre on all patients undergoing surgery.

2. Aggregation and validation of the data

3. Analysis and development of risk stratification models for outcome measures

4. Regular feedback of risk adjusted clinical outcomes to contributing centres

5. Continuous evaluation of performance and changing practice and the influence of risk factors.

6. Intermittent governance analyses to look for surgeons or hospitals whose mortality rates are higher than expected

7. Publication of named surgeon and hospital mortality rates for patients and the public.

8. Intermittent comprehensive reports of trends and outcomes in cardiac surgery (The Blue Books). The most recent Blue Book (Demonstrating Quality) was published in 2009.

The SCTS adult cardiac surgery database programme was awarded the prestigious BMJ award for best quality improvement programme in 2010.

More recently we have started to explore what we see as the wider cultural benefits that are derived for the medical profession from programmes to collect and publish clinical outcomes. We have reported these thought in our recent publication 'Maintaining Patients’ Trust'.

Funding: Funding for collation and online analyses of the data for the adult cardiac surgery database project in England and Wales comes from the Healthcare Quality Improvement Partnership. This grant is awarded to UCL, London and the central cardiac audit database (CCAD) data collection infrastructure has recently migrated from the NHS Information Centre to the National Institute for Cardiovascular Outcomes Research (NICOR) at UCL. NICOR is now responsible for running all the cardiac national audits in conjunction with the associated professional societies (http://www.ucl.ac.uk/nicor/). Since September 2011 we are also in grateful receipt of a grant from the National Heart Research Fund, which funds an analyst who works on the SCTS database project at Manchester University.

The Dataset: The first agreed dataset was finalised in June 1996 and remained unchanged until 2003. This dataset was updated in and ran until April 2011. We have now made further modifications to the dataset, to bring it in line with current clinical practice.

Data Collection: Data is collected in all the centres and returned to a central source at the CCAD. All patient identifiers are anonymised in compliance with data protection legislation, but this is done in a way that allows long-term mortality to be tracked. The recent report ‘demonstrating quality’ contains 5 year CABG mortality rates on over 88,000 patients.

Further information: Further information about the adult cardiac surgery database agenda is available on request from sctsadmin@scts.org We also keep a number of up to date technical papers, details on the dataset, and records of analyses in progress. Plese click here for more information. Request for data for research purposes can be made through a data sharing agreement with the SCTS and NICOR. Please contact sctsadmin@scts.org

Thoracic

UK THORACIC SURGICAL AUDIT PROJECT: The SCTS is currently running two initiatives side by side. The first is the Thoracic Surgical Register, initially introduced in 1980 and extensively modified for data on activity from 2002-3 onwards. The second is the development of the more ambitious SCTS thoracic surgical dataset. The intention is for the extended dataset to take over and ultimately replace the thoracic register, in much the same way as has happened for cardiac surgery.

Thoracic Surgical Register: 2000–2001, 2001-2002, 2002-2005, 2005-2006, 2002-2006, 2006-2007, 2007-2008, 2008-2009. Summary register    2002 - 2009 excel

Thoracic Report 2008: Please select relevant file from the above, and also the latest accompanying letter dated May 2011.For the current round of data collection (2010-11), please click here to download a template for your returns.

SCTS Thoracic Surgery Dataset: Please click on link here for the associated thoracic dictionary and here for the thoracic dataset. I am aware that many thoracic surgical units do not have the infrastructure in place to collect the information required for this project. I suspect it will be many years before the dataset can replace the limited but very useful information provided by the Register. In the meantime the latter will remain as an excellent resource for many interested in UK thoracic surgery. Therefore the SCTS will continue to ask surgeons to provide the appropriate information to maintain an annual Register of thoracic surgical activity. If you have any questions of any sort please do not hesitate to get in touch with me. Richard D. Page, Consultant Thoracic Surgeon, Liverpool (SCTS lead for thoracic surgical audit) e-mail - richard.page@lhch.nhs.uk; Phone – 0151 600 1456

NATIONAL ACTIVITY & OUTCOMES (BLUE BOOK)

To download pdf versions of previous publications click here.