Innovative uses of a cardiothoracic database

This report describes the activities of the Northern New England Cardiovasc ular Disease Study Group. The group consists of representatives from six in stitutions: Eastern Maine Medical Center in Banger, and Maine Medical Cente r in Portland, ME; Optima Health Care in Manchester and Dartmouth-Hitchcock Medical Center in Lebanon, NH; Fletcher Alien Health Care in Burlington, V T; and Beth Israel-Deaconess Medical Center in Boston, MA. The Northern New England Cardiovascular Disease Study Group maintains a voluntary primary c ardiac surgical database that has risk-stratified information on more than 60,000 consecutive patients who have undergone open heart surgical procedur es in northern New England since 1987. In 1991, the group reported that sig nificant variation in mortality rate existed between centers, a difference not explained by case mix. The finding led to a regional retrospective revi ew of deaths in an effort to identify "mode of death." Mode of death is def ined as that event that started the chain of events ultimately leading to t he death of the patient. The most common mode of death was found to be low cardiac output syndrome. This information has led to a regional effort towa rd prevention, early recognition, and successful treatment of low cardiac o utput syndrome in the perioperative period. (C) 1999 by The Society of Thor acic Surgeons.