Heart Surgery and Intervention Outcomes for California Hospitals

California Cardiac Surgery Intervention Project

The California Cardiac Surgery and Intervention Project (CCSIP), an initiative of the California Society of Thoracic Surgeons (CASTS), has been dedicated to data collection, study of best practices, and performance improvement since 2003. The California Office of Statewide Health Planning and Development (OSHPD) reports provider-level mortality rates of CABG procedures, as well as hospital-level "Inpatient Mortality Indicators" on various other procedures, including PCI, at https://www.oshpd.ca.gov/HID. The CCSIP, using similar data sources, produces comprehensive reports that include additional adverse event indicators and outpatient information for PCI, CABG and Valve procedures. CCSIP reports are now available to heart team members, health care providers and other stakeholders, including consumers, based on registration and agreement to terms of use on the Login tab.

Support

The CCSIP has been supported by the non-profit CASTS and by unrestricted grants from several non-profit foundations. The reports are an important source of information not only to heart team members but to all stakeholders, including patients and companies that manufacture heart valves and other medical devices. The CCSIP depends on the support of the participants in the performance of cardiovascular procedures. To support the CASTS and its projects, please click on the SUPPORT CASTS/CCSIP button on the CASTS home page.

Data Sources and Methods

This website includes statewide and hospital-specific reports obtained from the patient discharge (PDD), emergency department (ED) and ambulatory surgery (AS) databases provided by OSHPD to eligible faculty members of the University of California. The data is analyzed as decribed in a protocol approved by the Committee for the Protection of Human Subjects at OSHPD. Reports are posted on all adult coronary artery bypass graft (CABG), aortic valve, mitral valve, percutaneous coronary intervention (angioplasty or PCI), and certain other invasive heart procedures performed in California from 1999 through 2018.

The surgery groups for which data are presented are following the approach adopted for public reporting in New York and Pennsylvania. These states combine isolated valve and CABG/valve groups for outcome reporting, which allows more complete reporting by increasing volume numbers for lower volume hospitals.

Starting with 2018, we have added volume and outcomes data for Transcatheter Aortic Valve Replacement (TAVR).

Our methods and this website were revised extensively to accommodate feedback received from users of our previous reports. Volume and event counts listed here may differ slightly from provider counts or registry data. For a review of this and other issues please refer to the Methods/FAQ tab for a more detailed discussion.

Report Sections

The Volume Summary section provides a brief summary of California-wide trends in cardiac surgeries and interventions from 1999 to 2018.

The Surgery Volume section provides detailed hospital-level data on the volume of isolated CABG, isolated valve procedures with and without CABG, and other cardiac surgeries as well as Percutaneous Coronary Interventions with and without ACS. Also provided is more detail on the type of valve procedures performed with and without CABG.

The Mortality section provides detailed hospital-level data on mortality outcomes after isolated CABG surgery, isolated valve procedures with and without CABG surgery, PCI with ACS and PCI without ACS. Mortality is based on deaths that occurred during the surgery admission or acute care admissions following transfer after the index surgery/intervention that were connected to the index admission and in-hospital / emergency room deaths that occurred after a discharge home and within 30 days of the procedure. Note that this measure is similar to the STS operative mortality measure (see Which outcomes after cardiac surgery / intervention are shown?).

The MACCE section provides detailed hospital-level data on Multiple Adverse Cardiac and Cerebrovascular Events (MACCE) after isolated CABG surgery, isolated valve procedures with or without CABG, PCI with ACS and PCI without ACS. The MACCE outcome is based on death, post-operative stroke, post-operative acute myocardial infarction or non-elective re-intervention during the index admission or during acute care admissions following transfer after the index surgery/intervention that were connected to the index admission.

The MACCE-90 section provides detailed hospital-level data on Multiple Adverse Cardiac and Cerebrovascular Events (MACCE) within 90 Days of isolated CABG surgery, isolated valve procedures with or without CABG, PCI with ACS and PCI without ACS. The MACCE-90 outcome includes the same events as the MACCE outcome; in addition, acute care re-admissions within 90 days are also included in outcome identification.

The Methods section provides a rich source of background information, definitions applicable for this project, details on the risk-adjustment process and details on all risk-adjustment models used.

Please use the contact information in the Contacts to direct any further questions to CCSIP support.