Evolving a national congenital heart database in China:the urgent need and lessons from the STS and ECHSA experi-ence / 中华胸心血管外科杂志

ABSTRACT

There has been fast progress in congenital heart surgery in China in the past decades , and the annual number of cardiac operations is definitely the largest in the world .However, the lack of a national database in congenital heart surgery has limited the effective comparisons of clinical management and outcomes among centers .This clearly impedes the improve-ment in quality of care for children with congenital heart disease , as learned from the experiences in the development of the two most important congenital heart databases, i.e., the European Congenital Heart Surgeons Association(ECHSA) database and the Society of Thoracic Surgeons(STS) database in the US.Therefore, this article, firstly, described the brief history of ECH-SA and STS databases in the past 2 decades.Secondly, the 8 mechanisms that have been developed in the STS database were introduced, consisting of basic information, nomenclature, database-registry, mechanism of evaluating case complexity together with surgical outcomes, mechanism to verify data validity and accuracy, collaboration between subspecialties, longitudinal fol-low-up and linked databases and quality improvement .These mechanisms have helped to effectively evaluate and compare the surgical outcomes in terms of quantity and quality among centers .The national database has played a crucial role in improving the quality of care for children with congenital heart disease .Thirdly, the urgent need and the main obstacles of developing a national database in congenital heart surgery in China were pointed out , as currently the cardiac centers are still evaluated based on the quantity of operations, but not quality.This article aimed to provide a reference for the establishment of a national con-genital heart database in China.