Section S

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.
Section A: seq# 40-80				Section F: seq# 750-870		Section K: seq# 1630-1880		Section P: seq# 2710-3010
Section B: seq# 100-210				Section G: seq# 890-1040		Section L: seq# 1920-2350		Section Q: seq# 3020-3080
Section C: seq# 220-340				Section H: seq# 1050-1200		Section M: seq# 2360-2560		Section R: seq# 3090-3210
Section D: seq# 350-550				Section I: seq# 1210-1500		Section N: seq# 2570-2600		Section S: seq# 3220-3240
Section E: seq# 560-670				Section J: seq# 1520-1620		Section O: seq# 2610-2700
2. To review an individual Seq# clinical question, click on the Seq# title below. 310 ICUInHrs 2470 OCarAFib 340 TotHrICU 2560 OCarOthr 440 RenFail 2710 Complics 490 InfEndo 2750 COpReOth 850 ArrhyTyp 2780 CISternDeep 1050 NumDisV 2830 CNStrokP 1260 EmergRsn 2950 COtCoag 1280 OpCAB 3090-3180 Section R. 1310 OpOCard 3220 Readm30 1380 PerfusTm 3240 ReadmPro 1410 XClampTm 1640 OpMitral 1650 OpTricus 3. CC/TM: Corrections/Clarifications to Training Manual
NEW	Date	SeqNo	FieldName		Definition
		3220	Readmit<=30Days from DOP		Indicate whether the patient was readmitted as an in-patient within 30 days from the date of initial surgery for ANY reason.
	3/04				If a patient is readmitted to an inpatient rehabilitation hospital, would that be considered an inpatient readmission?		Although the training manual states that the readmission does not have to be to the same institution as the primary surgical procedure, the training manual and definition do not make clear that the intent of seq# 3220 is to capture readmissions to acute care, primary care institutions only. Do not include readmissions to rehabilitation hospitals, nursing homes etc.
	6/04				We have an occasional patient that is readmitted twice within the 30 day time frame from the date of the procedure. Do we count both readmissions? If we only count one readmission, should we count the first readmission? What if the 2nd readmission includes a significant procedure and the 1st readmission does not?		The key word here is "occasional". The intent of the field is to capture the first readmission even if it is not related and even if the second admission is more significant. We are banking that the first readmission will be the significant readmission. The Task Force talked about adding additional fields to capture a second readmission, but thought that for the occasional patient this would not be necessary.
	6/04				At out institution patients are being readmitted within 30 days as STO (Short term Observation) for up to 72hours. Should I be coding this as a readmission?		Due to the variation between institutions definitions of STO; these types of readmissions need to be coded as a readmission if the readmission occurs within 30 days. It is the opinion of the Task Forces that the patient is being admitted, receiving care, and generating a bill, thus for the purposes of the STS, these types of readmission should be coded as a readmission.
	12/04				I have a few patients who have been re-admitted to the hospital after CABG for reasons that were planned (ex, colon resection or cholecystectomy). Should this be coded as re-admission within 30 days and if so, should it go under other?		Yes, these readmissions should be coded. The STS is interested in anytime the patient is readmitted to a hospital <= 30 days from the date of procedure irregardless if the readmission was planned or unplanned, related or unrelated. For seq# 3220, Readmit Reason there are harvest code options of "Other - Related Readmission" and "Other - Nonrelated Readmission.
	1/05				Please explain the difference between "Anticoagulant Complications-valvular" and "Anticoagulant Complication-Pharmacological."		"Anticoagulant Complications-valvular" relates to thrombus forming in the annulus of the prosthetic valve. "Anticoagulant Complication-Pharmacological" refers to more general complications from anticoagulant medication.
NEW!	08/06				A patient is readmitted as ambulatory surgery observation patient not an inpatient but was in hospital for 3 days and had insertion of Pleux catheter . Would you collect as readmission since he was not inpatient.		Yes this patient is counted as readmission.
NEW!	08/06				Readmit <=30 from DOP Message: I am unsure how to abstract a patient who admitted to our hospital and had a CABG, then has complications that required a BiVAD. The patient was transferred to another acute hospital for continuing care because of the BiVAD. The transfer was immediately from our facility to the next one, so I would assume it is a readmission within 30 days, but am unsure as to what readmit reason I would use because it is VAD related, but not a VAD complication. Should I just use Other-Related admission? Thank you for your help.		The transfer the the acute care facility is a readmission. Readmit reason is Other related if the BiVAD is inserted in your institution.
NEW!	08/06				ReadmRsn Message: If a patient has 2 readmissions within 30 days should you take the 1st readmission or the one that seems most critical. For example a pt readmitted 11 days po for pleural / pericardial effusion and has thoracentesis. Then readmitted 17 days po and has pericardiocentesis. Which should be collected ?		Collect the information for the 1st readmission to the hospital and the reasons for that admission.
		3230	Readmit Reason		Indicate the primary reason that the patient was readmitted as an in-patient within 30 days from the date of initial surgery (select one): Anticoagulation Complication - Valvular Anticoagulation Complication - Pharmacological Arrythmias/Heart Block Congestive Heart Failure Myocardial Infarction and/or Recurrent Angina Pericardial Effusion and/or Tamponade Pneumonia or other Respiratory Complication Coronary Artery Dysfunction Valve Dysfunction Infection - Deep Sternum Infection - Conduit Harvest Site Renal Failure TIA Permanent CVA Acute Vascular Complication Subacute Endocarditis VAD Complication Other - Related Readmission Other - Nonrelated Readmission
CC/TM	2/04				The harvest code options listed above for seq# 3230 are listed incorrectly on the non-annotated Data Collection Form for version 2.52 (this error has since been corrected and the new document reposted on sts.org) and in the training manual. Please make a note that the harvest options listed here and in the data specifications are correct.
	12/04				I have a few patients who have been re-admitted to the hospital after CABG for reasons that were planned (ex, colon resection or cholecystectomy). Should this be coded as re-admission within 30 days and if so, should it go under other?		Yes, these readmissions should be coded. The STS is interested in anytime the patient is readmitted to a hospital <= 30 days from the date of procedure irregardless if the readmission was planned or unplanned, related or unrelated. For seq# 3220, Readmit Reason there are harvest code options of "Other - Related Readmission" and "Other - Nonrelated Readmission."
		3240	Readmit Reason Primary Procedure		Indicate the primary procedure that the patient received after being readmitted as an in-patient within 30 days from the date of initial surgery (select one): OR for Bleeding Pacemaker insertion/AICD PCI Pericardiotomy/Pericardiocentesis OR for Coronary Arteries OR for Valve OR for Sternal Debridement/Muscle Flap Dialysis OR for Vascular No Procedure Performed Other Procedure Unknown
		3250	Predicted Risk of Mortality		Calculated from software.
		3260	Predicted Deep Sternal Wound Infx		Calculated from software.
		3270	Predicted Reoperation		Calculated from software.
		3280	Predicted Permanent Stroke		Calculated from software.
		3290	Predicted Prolonged Ventilation		Calculated from software.
		3300	Predicted Renal Failure		Calculated from software.
		3310	Predicted Morbidity or Mortality		Calculated from software.
		3320	Predicted Short Length of Stay		Calculated from software.
		3330	Predicted Long Length of Stay		Calculated from software.