Contact: Ellen Bank
843.792.2626
March 27, 2002
CHARLESTON, SC -- A comparison of mortality
rates from 54 pediatric cardiac surgery centers in the U.S. and Canada
shows that pediatric cardiac surgical mortality rates at the Medical
University of South Carolina (MUSC) in Charleston are well below the
average of all centers for all procedures analyzed. Lower mortality
rates clearly indicate positive outcomes for MUSC patients.
The pediatric cardiac surgery service at MUSC is the only one in
South Carolina. In collaboration with pediatric cardiologists in
Greenville, Columbia and Florence, it serves patients from the entire
state through the ChildrenŐs Heart Program of South Carolina. The
Pediatric Cardiac Care Consortium (PCCC) just released the analyzed data
from its member centers for the period 1996 to 2000. The following data
were generated for each of 18 cardiac procedures: number of operations,
observed deaths, percent mortality, expected deaths for the procedure
based on PCCC norms, and the standardized difference (permitting
comparison of MUSC to all the institutions). A standardized difference
(SD) below 0 indicates better performance than the average, a value
above 0 is worse. A value less than -2 is significantly better than
average. The overall mortality rate for all institutions was 6.7
percent, and the mortality rate at MUSC was about a quarter of that,
1.58 percent. MUSC mortality rates were below the average of the other
institutions for the 13 procedures where the number of operations was
sufficient to derive statistically significant data,. In the procedures
where there were not enough data for statistically significant
comparisons, MUSC generally had no deaths.
One of the areas where MUSC mortality rates were dramatically
below average was the Norwood procedure, which is the first stage of
repair for an infant born with only a single functioning heart pumping
chamber, or ventricle, and no aorta. During the period of the study,
63 of these cases were done at MUSC with 10 deaths prior to 30 days
after the procedure, translating to a 15 percent mortality rate. The
average mortality rate for this procedure at all the centers was about
3.5 times as high at 50 percent.
"Two superb pediatric cardiac surgeons, Fred Crawford, M.D.
and Scott M. Bradley, M.D., and a dedicated group of pediatric cardiac
intensivists are probably the biggest factors in our success," said
J. Philip Saul, M.D., medical director for childrenŐs services at
MUSC. "Further, as the only pediatric cardiac surgical center in South
Carolina, we do a larger volume of procedures than some of the other
centers, so there are sufficient cases to be a center of true
excellence. In North Carolina, for example, there are five competing
centers with the result that no one center can produce the kind of
outcomes that we do." He also attributes MUSCŐs success to a strong
team approach, providing everything the patient needs, including
dedicated pediatric cardiac surgeons, intensive care specialists,
catheterization specialists, imaging specialists and anesthesiologists.
"The bottom line,Ó he said, Ňis you need a team of specialists,
all practicing state-of-the-art care and all dedicated to children."
The PCCC was developed about 15 years ago when it was recognized
that there was a wide variation in outcomes among pediatric cardiac
centers in the U.S.. It operates as a self evaluation mechanism where
patient outcome data from each member center go to a central data base
located at the University of Minnesota Hospital and Clinic. The group
processes data and compares centers to let individual members know how
they compare to the others institutions. Centers not doing well can see
where they need to make improvements.
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