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RACHS-1 Pediatric Heart Surgery Mortality Rate (PDI 06)

CBE ID
0339
1.4 Project
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
1.3 Measure Description

In-hospital deaths per 1,000 pediatric heart surgery admissions among patients with congenital heart disease ages 17 years and younger. Excludes obstetric discharges; cases with transcatheter interventions as a single cardiac procedure, performed without bypass but with catheterization; cases with septal defect repairs as single cardiac procedures without bypass; cases with heart transplants; premature infants with patent ductus arteriosus (PDA) closure as the only cardiac procedure; age less than 30 days with PDA closure as only cardiac procedure; transfers to another hospital; cases with an unknown disposition; and neonates with birth weight less than 500 grams.

[NOTE: The software provides the rate per hospital discharge. However, common practice reports the measure as per 1,000 discharges. The user must multiply the rate obtained from the software by 1,000 to report in-hospital deaths per 1,000 hospital discharges.]

        • 1.14 Numerator

          Number of deaths (DISP=20) among cases meeting the inclusion and exclusion rules for the denominator.

        • 1.15 Denominator

          Discharges, for patients ages 17 years and younger, with either
          • any-listed ICD-9-CM procedure codes for congenital heart disease (1P); or
          • any-listed ICD-9-CM procedure codes for non-specific heart surgery (2P) and any-listed ICD-9-CM diagnosis codes for congenital heart disease (2D).

        • Exclusions

          Exclude cases:
          • with any-listed ICD-9-CM procedure codes for closed heart valvotomy (3AP) as the only congenital heart disease procedure and any-listed ICD-9-CM procedure codes for catheterization (6P) without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with any-listed ICD-9-CM procedure codes for atrial septal enlargement (3BP) as the only congenital heart disease procedure and any-listed ICD-9-CM procedure codes for catheterization (6P) without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with any-listed ICD-9-CM procedure codes for atrial septal defect repair (3CP) as the only congenital heart disease procedure and any-listed ICD-9-CM procedure codes for catheterization (6P) without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with any-listed ICD-9-CM procedure codes for ventricular septal defect repair (3DP) as the only congenital heart disease procedure and any-listed ICD-9-CM procedure codes for catheterization (6P) without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with any-listed ICD-9-CM procedure codes for other surgical occlusion (3FP) as the only congenital heart disease procedure and any-listed ICD-9-CM procedure codes for catheterization (6P) without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with patent ductus arteriosus (PDA)† and any-listed ICD-9-CM procedure codes for catheterization (6P) without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with any-listed ICD-9-CM procedure codes for atrial septal defect repair and enlargement (4P) as the only congenital heart disease procedure without any-listed ICD-9-CM procedure codes for extracorporeal circulation (5P)
          • with any-listed ICD-9-CM procedure codes for heart transplant (7P)
          • with any-listed ICD-9-CM diagnosis codes for premature infant (4D) and PDA†
          • with any-listed ICD-9-CM diagnosis codes for atrial septal defect or ventricular septal defect (5D) and PDA†
          • age less than or equal to 30 days with PDA†
          • transferring to another short-term hospital (DISP=2)
          • neonates with birth weight less than 500 grams (Birth Weight Category 1)
          • MDC 14 (pregnancy, childbirth and pueperium)
          • with missing discharge disposition (DISP=missing), gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing) or principal diagnosis (DX1=missing)

          † PDA is defined as any-listed ICD-9-CM diagnosis code for PDA† closure (3D) as the only congenital heart disease diagnosis code besides atrial septal defect or ventricular septal defect (5D), and any-listed ICD-9-CM procedure code for occlusion of thoracic vessel (3EP) as the only congenital heart disease procedure code.

          See Pediatric Quality Indicators Appendices:
          • Appendix I – Definitions of Neonate, Newborn, Normal Newborn, and Outborn
          • Appendix L- Low Birth Weight Categories

        • Most Recent Endorsement Activity
          Measure Retired and Endorsement Removed Surgery Fall Cycle 2017
          Initial Endorsement
          Last Updated
          Removal Date
        • Steward
          Agency for Healthcare Research and Quality
          Steward Organization POC Email
          Steward Organization Copyright

          The AHRQ QI software is publicly available; no copyright disclaimers