Heart surgery programs typically report their overall survival rate as well as survival rates based on the complexity of the surgery. At Children’s Colorado, our overall survival for all cardiac surgery patients, regardless of surgical complexity, is 97.3%. The national average is 97.1%.
Cardiac surgery survival rate at Children's Colorado
Source: STS July 2014 through June 2019
Cardiac surgical survival by complexity
Some congenital heart defects are more complex than others. Because there are so many types of heart defects, no pediatric heart program will see the exact same types of heart defects each year. The Society of Thoracic Surgeons (STS) organizes the types of surgeries into five categories of complexity, which are referred to as “STAT categories.”
About STAT categories
STAT categories organize heart surgeries into groups based on how risky or complex they are. The STAT 1 category indicates surgeries with the lowest risk of death, while the STAT 5 category indicates the surgeries with the highest risk of death. A hospital that has a high survival rate for STAT 5 cases indicates success at handling unpredictable situations during the operation and in recovery.
For STAT 5 neonatal surgeries, the most complex, the Heart Institute's survival rate is 88.2%, higher than the national average.
STAT 5 newborn cardiac surgery survival rate at Children's Colorado
Source: STS July 2014 through June 2019
Cardiac surgery mortality
Surgery programs also report mortality, which is the percentage of patients who did not survive their operation. (The more complex the surgery, the higher the risk of mortality.)
Below are Children’s Colorado’s cardiac surgery mortality rates by STAT category, age of the patient and type of surgery.
Surgical outcomes: Adjusted mortality rate (AMR) by age
||Observed mortality rate Children's Colorado
||Expected mortality rate Children's Colorado
||Adjusted mortality rate Children's Colorado (95% confidence interval)
|Newborns + Infants
|Newborns + Infants + Children
|Newborns + Infants + Children + Adults
About adjusted mortality rate
The adjusted mortality rate (AMR) is a statistical evaluation developed by the STS that predicts a patient’s risk of undergoing surgery. This evaluation attempts to include patient-related risk factors prior to surgery, such as age, weight and genetic factors, in addition to the patient’s surgical risk. Using this method, the STS compares the actual patient outcomes (observed outcomes) to expected outcomes (those predicted by the statistical model). Ultimately, a heart center should strive to have observed mortality that is the same or less than the expected mortality.
Index case mortality
July 2014 through June 2018
|By specific operation
||Total operations Children's Colorado
||Children's Colorado mortality
|Arterial switch repair
|Arterial switch repair + Ventricular septal defect
|Atrioventricular canal defect repair
|Glenn / Hemi-fontan
|Tetralogy of Fallot repair
|Ventricular septal defect repair
|Off bypass coarctation of the aorta
Average length of stay
The chart below shows the average number of days that children stay in the hospital for heart surgery, by STAT category. Cardiac surgery patients at Children’s Colorado spend less time in the hospital than the national average, indicating that they receive high quality care in the hospital that helps them go home sooner. The longer kids stay in the hospital after surgery, the more likely they are to have complications.
How is the Heart Institute at Children's Colorado working to improve our surgical survival rates?
At the Heart Institute at Children's Colorado, we continue to pursue ways of providing excellent patient care and outcomes. To continue this endeavor, we have implemented a number of quality-improvement initiatives to help enhance our performance and continue doing what we do best: fixing little hearts. Some of our initiatives include:
- Optimizing nutrition and growth of our patients
- Reducing surgical site and catheter-related blood stream infections
- Decreasing the number of days a patient stays in the hospital after heart surgery
- Continuous review of individual patient outcomes to ensure that each patient had the best care possible
The Heart Institute approaches patient care as a team. Our team consists of specialized physicians, anesthesiologists, nurses, nutritionists, perfusionists, respiratory therapists, pharmacists and lab technicians. Our team approach ensures that every patient receives the best care possible, customized for each and every child.
Why do we measure surgical survival at the Heart Institute?
Survival after heart surgery is the most important measure of the success of a cardiac surgical procedure (although it is not the only outcome we routinely monitor and analyze). The number of children and adults who survive surgery for congenital heart disease has increased significantly over the last 15 years, which has helped us concentrate on preventing complications that may occur during a hospital stay after heart surgery.
In addition to survival rates, the STS database includes important information about surgical complications. This information allows us to analyze survival data in conjunction with complication data, so we can compare ourselves to other programs across the country. Comparisons with other top institutions help us better understand how we are performing as a program, as well as identify areas for improvement.
Learn more about the Heart Surgery Program at Children's Colorado.
About this data
What is surgical survival?
According to STS, "surgical survival" is defined as being alive at least 30 days after a procedure and having been discharged alive from the hospital. Utilizing the STS definition ensures that institutions across the country are using consistent data reporting methods. The STS report is updated every six months.
What is the source of this data?
This information is from the STS Congenital Heart Surgery Database, which is the largest congenital heart surgery database in the world.
Do we have a national benchmark?
Yes, the STS database allows us to compare our outcomes to other congenital heart surgery programs in North America. We, along with these other programs, submit data to the STS twice a year. The STS verifies the integrity of the data and generates reports that allow us to compare results with our peers across the country.
How often should the data be updated?
We continually track patient outcomes and will publicly report data on this website.