Section A

The Society of Thoracic Surgeons

Frequently Asked Questions: General Thoracic Database

Version 2.07

October, 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# 10 - 190	Section C: seq# 285 - 650	Section E: seq# 770 - 1210
Section B: seq# 200 - 260	Section D: seq# 660 - 750	Section F: seq# 1220 - 1340

2. To review an individual Seq# clinical question, click on the Seq# title below.

Participation in both General Thoracic and Adult Cardiac Databases

GENERAL STATEMENT #2

Seq# 200: Zubrod Score Seq# 775: Postop Events

Seq# 300: WtLoss3Kg Seq# 860: Pneumonia

Seq# 310: Category of disease Seq# 930: Other Pumonary Event

Seq# 390: PreOp Chemotherapy Seq# 940: Atrial Arryhthmia

Seq# 400: PreOp Thoracic RT Seq# 1020: Anastomotic leak

Seq# 430: Other Cormorbidity Seq# 1190: Empyema

Seq# 540: Clinical Stage Not Applicable (2.06) Seq# 1200: Other event req. Rx

Seq# 725: Reoperation Seq# 1250: 30 Day Status

Seq# 740: Procedure Seq# 1280: Chest Tube Out Date

Seq# 750: Primary Procedure

Seq# 751: Thoracoscopy Approach

NEW

Date

SeqNo

FieldName

Definition

3/06

Participation in both General Thoracic and Adult Cardiac Databases

We participate in both Adult Cardiac and General Thoracic Database. Our question pertains to whether the patient should end up in both databases. Scenario--We had a patient who had an aortic aneurysm repair (arch/descending thoracic)and was entered into the Adult Cardiac Database. Less than 30 days after original surgery, he is readmitted with chylothorax, and undergoes Thoracic Duct Ligation. We recorded the surgery as an "other procedure" under Procedure performed on readmission. Our question really is whether we should enter the patient into the Adult Cardiac Database for the first surgery, but enter them into the General Thoracic Database for the second surgery (which was a complication of the first).

Yes, enter into both. In the Adult Cardiac DB, the primary procedure would be Seq# 1310 OpOCard=Yes; Seq# 2510 ONCAoAn=Yes; Seq# 2530 ONCArch=Yes; Seq# 2540 ONCDesc=Yes; Seq# 3220 Readm30=Yes; Seq# ReadmRsn=either Pneumonia or other Respiratory Complication or Other-Related Readmission; Seq# 3240 ReadmPro=Other Procedure. In the GTDB, code Seq# 740 Proc=Thoracic Duct Ligation

3/06

We currently participate in the Adult Cardiac Surgery database and are considering participation in the Thoracic Surgery database. Could you please let me know what diagnosis codes this database covers, and if we just abstract charts from the Cardiothoracic Surgeons, or does it also include General Surgeons?

The diagnoses covered can be found on the v2.07 Data Collection Form (available on www.sts.org). Procedures included in the database should be performed by CARDIOTHORACIC surgeons only.

NEW!

10/06

Short Field Name: cardiac/pericardium/great vess
Message: In 2004 the STS adult cardiac vs. 2.41 was not capturing VAD patients. We had a patient that had a VAD inserted and the patient was captured in the GTS database under Cardiac/pericardium/great vessels. Should we have captured this patient in the Adult cardiac under other cariac knowing that some fileds were have been left blank? Please advise.

Yes, it should have been captured in the Adult Cardiac database.

NEW!

10/06

The diagnoses covered can be found on the v2.07 Data Collection Form (available on www.sts.org). Procedures included in the database should be performed by CARDIOTHORACIC surgeons only.

NEW!

10/06

If a patient has a mini-maze and a wedge resection at the same time, do I fill out a form for both the STS Adult Cardiac and STS Thoracic?

Yes.

8/04

GENERAL STATEMENT #1

In version 2.06 there is no field to capture surgeries that were completed with robotic assistance. The STS will consider adding a field to collect this data in the next version of the software.

12/04

GENERAL STATEMENT #2

Version 2.06: The General Thoracic Database:

1.) Designed to capture all General Thoracic procedures performed in the OR (OR, Endoscopy Suite, Out Patient Surgical Center) by a General Thoracic Surgeon, i.e., include those General Thoracic procedures that generate an operative note

2.) Designed to have a new Data Collection Form (DCF) populated each time a patient enters the OR to undergo a General Thoracic procedures performed by a General Thoracic Surgeon

3.) Designed to capture General Thoracic procedures performed by a General Thoracic Surgeon even if the OR visit is a return visit to the OR as a result of a postoperative event from a previous General Thoracic procedure

4.) Section E, "Post Operative Events is designed to only capture those postoperative events that result from the General Thoracic procedure for which the DCF was generated for in the first place

3/06

If a patient has a thoracic surgery by one surgeon, but during the same hospitalization he has another thoracic procedure by yet another surgeon is that second procedure captured in the other surgery field?

The 2nd procedure would be captured on a new data collection form (DCF).

NEW!

10/06

Are we to complete STS forms for the donor of a lung transplant? On the procedure list, "lung donor harvest" is an option. Would that impact our mortality rate??

Complete a data collection form for the transplant recipient only (no form for the donor). The lung donor harvest should be conducted by a surgeon at your facility and from a living donor (not cadaver).

NEW!

10/06

I have a general question as to whether or not cardiac surgery patients should be coded in the thoracic database when they have other procedures during the CABG admission. For instance, a CABG patient develops a sternal dehiscence. He is brought back to the OR for mediastinal exploration and sternal debridement. He is brought back to the OR again for additional cleanup and muscle flap with closure. Say he also has a tracheostomy or EDG at another point. Should these 3 procedures be coded in the thoracic database or should they be coded only as re-ops in the STS cardiac database? If they are to be coded in the thoracic database this brings up a prior question sent to you but not yet answered - what to do about post-op events. Post-op events have already been coded in the cardiac database. Many are related to the original CABG. Do these also get coded in the thoracic database (assuming these procedures are even coded as thoracic procedures)? The post op events renal failure, blood products) have no relationship to a tracheostomy or EDG. Please answer both parts of my question. Thank you

All postoperative events should be documented and are to be captured according to the surgeon who performs the procedure. It is assumed that a CV surgeon would be conducting the reops for sternal dehiscence, etc. in your example and if so, should be coded in the STS Adult Cardiac database. If a General Thoracic surgeon performs the re-ops they would be collected on the STS General Thoracic form. Any complications directly resulting from the thoracic procedures should be counted on the thoracic form as well. A separate data collection form should be completed for each visit the OR.

Operations Table Record Identifier

An arbitrary, unique number that permanently identifies each record in the participants database (note that unlike the PatID value, this does not identify the individual patient). Once assigned to a record, this number can never be changed or reused. The value by itself can be used to identify the record in the participant's database. When used in conjunction with the ParticID value, it can identify the record in the data warehouse database. The data warehouse will use this value to communicate issues about individual records with the participant. This value may also be at the warehouse to link to other clinical data.

Procedures Table Record Identifier

This field is the foreign key that links this record with the associated records in the "Operations" table.

Software vendor's identification

Software vendor's identification assigned by the STS.

Vendor's software version number

Vendor's software product version number identifying the software which created this record. Vendor controls the value in this field. Version passing certification/harvest testing will be noted at warehouse.

Version of STS Data Specification

Version number of the STS Data Specifications/Dictionary, to which the record conforms. The value will identify which fields should have data, and what are the valid data for those fields. It must be the version implemented in the software at the time the record was created. The value must be entered into the record automatically by the software.

Record complete

Indicate whether the record data is complete or not. This entry is made by the software data quality check process. This field does not impact a procedure's harvest status. It is intended as an internal quality control field for data managers at site.

Participant ID

Participant ID is a unique number assigned to each database Participant by the STS. A database Participant is defined as one entity that signs a Participation Agreement with the STS, submits one data file to the harvest, and gets back one report on their data. The ParticipantID must be entered into each record.

Operations Table Patient Identifier

The foreign key that links this record with the associated records in the "PatientInfo" table.

Demographics Table Patient Identifier

An arbitrary number that uniquely identifies this patient in the database. This field is the primary key that links this record with the associated records in the "STSData" table. The value in this field can not be a value that would identify the patient outside of the database (such as Medical Record Number or Social Security Number). Once a value is assigned to a patient, it can never be changed or reused.

100

Medical Record #

Indicate the hospital medical number assigned to the patient.

110

Patient's first name

Indicate the first name of the patient.

120

Patient's middle initial

Indicate the middle initial of the patient.

130

Patient's last name

Indicate the last name of the patient.

140

Social Security Number

Indicate the nine-digit Patients Social Security Number (SSN). Although this is the Social Security Number in the USA, other countries may have a different National Patient Identifier Number. For example in Canada, this would be the Social Insurance Number.

150

Date of birth

Patient Date of Birth using 4-digit format for year. Harvest is Optional due to a variety of confidentiality issues at facilities. Participant will choose whether Harvest=Yes or

160

Patient's zip code

The ZIP Code of the patient's residence. Outside the USA, this data may be known by other names such as Postal Code (6 characters). Software should allow sites to collect up to 10 characters to allow for Zip+4 values. Harvest is Optional due to a variety of confidentiality issues at facilities. Participant will choose whether Harvest=Yes or Harvest=No.

170

Gender

Indicate the patient's gender at birth as either male or female.

180

Patient's race

Indicate the patient's race as determined by the patient or family.

NEW!

10/06

RACE
Message: My software vendor (Cedaron) says that we can choose more than one race in Version 2.07.

Is that the intent? When querying for race in the future, we will have to look at each race field independently. We can no longer click on Race and then filter out the one we want to look at. Doesn't seem correct.

Yes, the intent in Version 2.07 is to indicate the patient's race(s) as determined by the patient or family. Many national databases now include multiple options for race.

190

Age at time of surgery

Indicate the patient's age in years, at time of surgery. This should be calculated from the date of birth and the date of surgery, according to the convention used in the USA (the number of birth date anniversaries reached by the date of surgery).