|
Variable |
Issues |
|
Pre-Operative Risk Factors |
How to classify disease processes that was not part of patients history but appeared on admission (i.e. diabetic with elevated glucose and given some sub-q insulin) |
|
Pre-Operative Cardiac Status: Angina |
How to account for variation in geographic or practice treatment methodology of angina. (random use of NTG and admission to ICU). Time frame again was issue a) presentation to hospital or b) presentation to surgery. |
|
Preoperative Patient History-Risk Factors |
How to code non history disease processes but diagnosed on admission (i.e. diabetic with no history but has elevated glucose on admit and placed on oral or insulin) Diabetic Control: should treatment method be a chronic use and if so what time frame Immunosuppressive Tx: does this apply to one time doses or steroidal inhalers? |
|
Preoperative Patient History-Cardiac Medications |
Do one time doses count as mediations within 24 hours of surgical procedure? What defines a thrombolytic, anticoagulant or antiplatelet? |
|
PreOperative MI |
|
|
|
|
|
Variable |
Issues |
|
NYHA and CCS Classifications |
NYHA is strictly functional status or heart failure, CCS is anginal status. How can one measure status in hospital? Does this refer to time or surgery, time of admission? Does this refer to highest level at any of these time frames? |
|
MICS Section |
|
|
Re-Intubation |
Is it ventilation or extubation? |
|
Reop for bleed and tamponade |
Questions raised about opening chest in ICU, does this get coded as a return for reop bleed |
|
Post-Op Wound infection |
|
|
Operative Mortality-Yes/No as related to mortality location |
Question raised regarding the use of extended care for potential "gaming" of deaths Define what includes an extended or acute care facility and its relationship to op mort. Definition |
|
Complications Return to OR |
Do return to the OR for trach, PEG tubes, AICDs, bowel resections, dialysis access count as "Reop non-Cardiac"? |
|
|
|
|
Variable |
Issues |
|
Predicted Risk Score for Population and /or individual patient |
There currently is no possible way to generate a pred risk for an individual patient or patient population with the various risk categories like there was in the Summit software. Is this the responsibility of the STS or Vendors? |
|
Blood Product |
What constitutes Blood product |
|
# of Incisions in MICS section |
|
|
EF Value |
Can the STS assign value to text documentation? Method of reducing the % of missing EF values |
|
Readmission |
Concern regarding the report variations within regions and national when some sites follow patients to the 30 days and others do not. Sense of being penalized for following patients and increased occurrences. |
|
Specification Fields |
How do handle missing data fields (i.e numerical EF, PA mean) |
|
|
|
|
Variable |
Issues |
|
Non-Submitting Sites |
Concern over ability to harvest this fall due to vendor certification and conversion of data. Many sites do not feel they will be able to meet the deadline and if they do will have incomplete data sets for specified time frames |
|
Non-Submitting Sites and Report |
How to handle non-submitting sites and request for national report |
|
MICS section |
Cumulative ischemic times - ? delete |