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The Society of Thoracic Surgeons Frequently Asked Questions: Adult
Cardiac Surgery Database Version 2.52.1 August, 2006 How to use the interactive FAQ Document: 1. To
review all clinical questions in an individual section, click on the section
title below. |
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Section O:
seq# 2610-2700 |
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2.
To review an individual Seq# clinical question, click on the Seq# title
below. 1280 OpCAB
3090-3180 Section R. 3. CC/TM: Corrections/Clarifications to Training
Manual |
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NEW |
Date |
SeqNo |
FieldName |
Definition |
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2610 |
Blood Prod |
Indicate whether blood products were
transfused any time postoperatively. Postoperatively
is defined as any blood started after the initial surgery. Include blood transfused after the initial
surgery, including any blood transfused during a reoperative surgery. |
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4/04 |
Does autologous blood count when coding this field? |
Do not count pre-donated (autologous) blood, cell saver,
pump residual and/or chest tube recirculated blood. |
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2620 |
Blood Prod-RBC Units |
Indicate the number of units of Red
Blood Cells that were transfused any time postoperatively. |
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2630 |
Blood Prod-FFP Units |
Indicate the number of units of Fresh
Frozen Plasma that were transfused any time postoperatively. |
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2640 |
Blood Prod-Cryo Units |
Indicate the number of units of
Cryoprecipitate that were transfused any time postoperatively. |
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2650 |
Blood Prod-Platelet Units |
Indicate the number of units of
Platelets that were transfused any time postoperatively. |
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6/04 |
It is imperative that each site
understand their institutions definition for Random Donor Platelets (RDP)
and Single Donor Platelets (SDP) when coding seq# 1500, Intraop Blood
Products Platelet Unit and seq# 2650, Blood Products - Platelet Units. Because
of platelet unit definition variation between institutions, A ten pack of
platelets = 10 units, not one unit is no longer applicable. Following is a guideline for assessing platelet utilization across multiple
medical centers. RDP:
count the dose pack as one unit.
A dose pack may consist of 4, 6, 8, 10 or any number of donor
platelets obtained from random donors. The number of units coded is not
volume dependant. SDP or Plateletpharesis: count as one unit. One unit is compromised of platelets
derived from a single donor. The
number of units coded is not volume dependant. |
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2660 |
Extubated in OR |
Indicate whether the patient was
extubated prior to leaving the OR during the initial surgery. |
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1/05 |
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Seq# 2660-2700, Intubation Fields |
If a patient is transferred to
another hospital and remains intubated and on the ventilator at the time of
transfer what date/time is used as the time of extubation? |
Use the patients discharge date and time. |
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4/05 |
OR to ICU, patient intubated. ICU, patient extubated. Back to OR, intubated and extubated in
OR. Do not count OR Reop intubation as
a re-intubation. Reop OR intubation
hours do not get captured. |
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OR to ICU, patient intubated. ICU, patient extubated. Back to OR, intubated. Back to ICU remains intubated. Reintubated during hospital stay =
yes. Additional vent hours start once
patient arrives back in ICU. Do not
include operative intubation times in the initial or additional vent hour
fields. |
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OR to ICU, patient intubated. Back to OR intubated from initial
surgery. Back to ICU remains
intubated. All ventilation hours are
initial vent hours, but vent time in OR is not counted. |
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2670 |
Initial Hours Ventilated |
Indicate the number of initial hours post operation for which the
patient was ventilated before any reintubation. Number of hours includes hours ventilated
post-operatively until removal of the endotracheal tube or if patient has
tracheostomy tube, until no longer ventilator dependent. Leave blank if the patient was extubated on
the operating table. Any patient
ventilated > 24 hours is coded as a Pulmonary Complication of
"Prolonged Ventilation", |
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From version 2.41 |
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How should
postop vent hours be counted? The definition
calls for leaving this field blank if extubation occurs on the table. There are two practical problems associated
with using a blank for extubation on the table. First, there will be an assumption of
on-table extubation when the field may have been left blank due to lack of
information, careless omission or other error. Second, the vendors have the option of
making Post Op Vent Hours Total a calculated field. Consider the following not-uncommon
scenario: The patient is extubated on the table, transported to the ICU where
re-intubation is required for 10 hours.
With a calculated field, Post Op Vent Hours Total = <NULL> +
10 = <NULL>. Both of these
problems are solved by using 0 for Initial Hours Ventilated when
extubation is on the table. |
Initial hours
ventilated should include the hours from postop intubation time to time of
extubation. This does not include
re-intubation time. Re-intubation
should be reported under Additional Hours Ventilated. For centers extubating in the OR, the
Postop Vent Hours = 0. ( |
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From version 2.41 |
6/03 |
Should
post-op vent time start at the end of surgery or when the patient leaves the
OR or when the patient arrives in the ICU? |
Post-op
vent times begin when the patient arrives in the ICU or your institutions
equivalent to an ICU. |
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From version 2.41 |
7/03 |
If
you have a patient that is extubated post-op but maintained for two days on
bi-pap to prevent reintubation, does the bi-pap time count towards initial
hours ventilated? |
The
intent of this field is to capture the number of hours that a patient was
ventilated postoperatively till removal of the endotracheal tube. Therefore, once the patient is extubated,
stop counting initial hours ventilated. |
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5/04 |
Do ventilator hours get documented by rounding up to single hours or
do minutes get included? |
Ventilator hours are calculated with a decimal point so that minutes
can be included. Examples: 0.1 = 6 minutes 0.25 = 15 minutes 0.5 = 30 minutes 0.75 = 45 minutes etc. |
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11/04 |
A patient with a tracheostomy begins ventilator weaning do we
include the weaning hours for seq# 2670?
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Weaning time= ventilator time. Capture
the number of initial hours ventilated post operatively until removal of the
endotracheal tube or if the patient has a trach, until no longer ventilator
dependent. |
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01/06 |
Initial extubation time-Does
the time start with admission to the ICU or with skin closure in the OR. |
General Statement #1 in the FAQ defines Pre-op",
"intra-op" and "post-op" defined according to the STS
Adult Cardiac Database. |
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2680 |
Re-intubated During Hospital Stay |
Indicate whether the patient was
reintubated during the hospital stay after the initial extubation. This may include patients who have been
extubated in the OR and require intubation in the postoperative period. |
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From version 2.41 |
8/03 |
I
had a patient return to the OR which required intubation. Patient was extubated prior to leaving the
OR. Is this a reintubation? |
No,
this would not be a reintubation because it was a required intubation for the
surgery. As long as the patient was
extubated in the OR, there is no reintubation and no additional vent hours. |
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8/04 |
Would self-extubation requiring immediate reintubation be collected as
a reintubation? |
As long as the reintubation was immediate, continue to collect as
initial # of hours ventilated postoperatively. If the patient was given a trial run once
extubated, which fails, requiring reintubation, these hours would count
towards additional hours ventilated post-op. |
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2690 |
Additional Hours Ventilated |
Indicate how many additional hours the
patient was ventilated postoperatively. |
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5/04 |
Do ventilator hours get documented by rounding up to single hours or
do minutes get included? |
Ventilator hours are calculated with a decimal point so that minutes
can be included. Examples: 0.1 = 6 minutes 0.25 = 15 minutes 0.5 = 30 minutes 0.75 = 45 minutes etc. |
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2700 |
Postop Vent Hours - Total |
Indicate the total number of hours
including any reintubation hours. Any
patient ventilated
> 24 hours should be coded as a Pulmonary Complication of "Prolonged
Ventilation". If extubated in the
OR and no additional ventilation hours, enter zero in this field. |
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From version 2.41 |
9/03 |
Does prolonged intubation include those hours after the initial
extubation which may have been less than 24hrs? Also if a patient was trached and was on
trach shield during the day but back on the vent at night, do we include
those vent hours? |
Total vent hours included all hours until patient is non-vent
dependent. It does include all
reintubation hours (excluding re-op OR intubation hours) and those hours of trach
collar/vent at night hours. |
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2/04 |
Improvement
of definition and additional clarification:
Indicate the total number of hours including any
reintubation hours. Any patient ventilated > 24
hours should be coded as a Pulmonary Complication of "Prolonged
Ventilation". If extubated in the
OR and no additional ventilation hours, because the patient expired in the
OR, this field would appropriately be left blank. If patient survived initial surgery,
extubated in the OR and no additional vent hours, enter 0, zero. Zero is the correct option for seq# 2700, VentHours, for the following
situation: If the patient survives and is extubated in the OR of the initial
surgery and requires no reintubation Seq# 2660: Extubated in the OR
= yes Seq# 2680: Re-Intubated during
hospital stay = no Seq# 2700: Total Hours
Ventilated Postop = zero Blank is the correct option for seq# 2700, VentHours, for the
following situation: If the patient expires in the OR of the initial surgery Seq# 2660: Extubated in the OR
= yes Seq# 2680: Re-Intubated during
hospital stay = no Seq# 2700: Total Hours
Ventilated Postop = blank |
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5/04 |
Do ventilator hours get documented by rounding up to single hours or
do minutes get included? |
Ventilator hours are calculated with a decimal point so that minutes
can be included. Examples: 0.1 = 6 minutes 0.25 = 15 minutes 0.5 = 30 minutes 0.75 = 45 minutes etc. |
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