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Cardiology Outcomes | 2013


Table of Contents 4 // Mechanical Circulatory Support and Heart Transplant 4 // Cardiac and Vascular Lab Procedural Volume 5 // Electrophysiology Procedures 6 // Heart Failure 30-day Readmission Rate 6 // Heart Failure Oberved/Expected Mortality Rate 6 // Open Heart Surgery at UCH 7 // Risk Adjusted Rates for Isolated CABG Patients 7 // Transcatheter Aortic Valve Replacement (TAVR) 7 // Kansas City Cardiomyopathy Questionnaire (KCCQ)


University of Colorado Hospital

is the leading academic medical center in the nation. University of Colorado Hospital (UCH) is recognized as the highest-performing academic hospital in the United States for delivering quality health care by the University HealthSystem Consortium for two years in a row, and is ranked as the best hospital in the Denver metro area and one of the best in the country by U.S. News & World Report. UCH is best known as an innovator in patient care and often is one of the first hospitals to bring new medicine to the patient’s bedside. The hospital’s physicians are affiliated with the University of Colorado School of Medicine, part of the University of Colorado system. Based at the expansive Anschutz Medical Campus in Aurora, Colo., UCH is where patient care, research and education converge to establish the future of health care delivery.

The University of Colorado Hospital Difference… No other hospital in the region can offer the wide range of cardiovascular services provided at the University of Colorado Hospital. Our multidisciplinary approach to cardiovascular care means more comprehensive, collaborative level of care resulting in better outcomes for our patients. The Cardiac and Vascular Center at University of Colorado Hospital is home to some of the best programs in the country. As an academic medical center, patients have access to the latest technologies, clinical trials, and medical treatment available. With our continued efforts to stay at the cutting edge of medical advances we are now participating in 15 clinical trials, in addition to being at the forefront of most clinical procedures nationally. With 12 cardiovascular specialties under one roof, lead by experts in varied subspecialties, the cardiovascular team at University of Colorado Hospital is trailblazing a higher standard of care…every day.

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OUTCOMES data Mechanical Circulatory Support and Heart Transplant

Mechanical Circulatory Support and Heart Transplant Post Implant Survival: June 23, 2006 to June 30, 2013 96%

93%

91% 93%

87%86%

National Data

UCH

64%

64%

81% 79% 69%

64%

58%

64% 46%

1 mo.

3 mos.

6 mos.

12 mos.

24 mos.

36 mos.

44%

48 mos.

KEY

60 mos.

Post Implant Survival: June 23, 2006 to June 30, 2013

* Within two years 20% of LVAD patients receive a successful heart transplant.

Title

Alive (device still in place) Death (before transplant) Transplant Explanted (recovery)

100%

Cardiac and Vascular Lab Procedural Volume 60% 46%

ates G

32% Peripheral Interventions 20% 10101 0%

0% 0% 0 mo.

33%

Structural Interventions 12% 28% 145

30%

2% 12 mos.

Coronary Interventions 52% 266

oke

4

386

1053 941

25% 23%

22%

20%

1%

6 mos.

49%

45%

Structural Interven+ons   2%

Coronary Interven+ons   18 mos.

24 mos.

Peripheral Interven+ons  

2%

UCH National Data


FY 2012

Title

FY 2013

Bi-V

ICD Implantation

Pacemaker Implantation

Ablation

DFT Checks

Cardioversion

FY09

FY10

531

23

FY12

Bi-V

Lead Extraction

DFT Checks

Ablation

ICD Implantation

Pacemaker Implantation

FY13

Highest Level of Education Possible — Every

performed including left atrial appendage

member of the faculty educated and trained at the best

exclusion, subcutaneous ICD implantation, and

medical schools and hospitals in the country: Harvard,

epicardial ablation

Penn, Hopkins, UCSF

Innovative Research — New ways to make

The last stop — high success rate for re-do ablations

in the lab and in clinical trials Culture of Safety — Our faculty define the safest approaches for arrhythmia care as part of a robust outcomes research program and they practice what they teach

FY14

Cardioversion

Full service — All arrhythmia procedures

ablation safer and more effective being evaluated

51

69

49

30

FY11

69

93

124

144

189 189

181

181 118

159 118 93 30

93

54

37

37

47

25 14 14

75

KEY

25

36

29 8 8

29

FY08

256

130

151

111 100 111

118

182

182

228

256

315

Title

531

690

Electrophysiology Procedures

690

Lead Extraction

Word is getting out — Dramatic increase in complex ablation volume The latest technology — Up to date equipment for state of the art facilities including Stereotaxis, Laser Lead Extraction

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OUTCOMES data Title Failure 30-day Readmission Rate Heart

Title

22.34

22.34

UCH

University

UCH

20.69

University 20.49 19.22 20.49 19.22

20.37

20.69

17.2720.37 17.27

KEY

FY 2011

FY 2012

FY 2011

Series1

UHC Reporting Hospitals Avg.

FY 2013

FY 2012

Title

UCH

FY 2013 Series2

Heart Failure Observed/Expected Mortality Rate 0.75 Series1 Series2

Title

0.67

0.75

0.61

0.67

0.61

0.45 0.45

KEY FY 2012

UHC Reporting Hospitals Avg.

FY 2013

FY 2012

Title

UCH

FY 2013 Bi-V

OpenTitle Heart Surgery atBi-VAblation UCH

National Quality Forum Measures for Open Heart Surgery

Pacemaker Implantation

ICD Implantation DFT Checks

Pacemaker Implantation Cardioversion

DFT Checks

Cardioversion

227

Ablation Lead Extraction

ICD Implantation

*Other includes: Aortic Aneurysm repair, Aortic Dissection, Aortic Trauma, Heart Transplant, Endovascular

531

Procedure, ASD repair, Trans Myocardial Laser, Congenital, Aortic Root, Atrial Fibrillation Procedure

15

6

690 690

690 690 531

Other

531

Valve and/or Valve CAB

UCH

531

CAB Only

KEY

Title Title

FY 13 Open Heart Volume Procedures Performed

100

98

Lead Extraction


PFO/ASD/VSD Closures

67

Pericardiocentesis

25

Left Heart

Intracardiac Echo Coronary Angiography

62

Title Diagnostic Right Heart Peripheral Procedures

276 1053

Risk Adjusted Rates for Isolated CABG 101 patients 386 Peripheral Interventions

443

Right Heart w/Vasodilator Right & Left Heart 9.7%

48

IVUS-Intravascular Ultrasound Biopsy

138

Congenital Diagnostic Procedures Angioplasty/Stent/Other PCI

11

NSRT/Septal Ablation 7 Congenital Intervention Procedures Valvular Interventions

67

PFO/ASD/VSD Closures

67

Thrombectomy Pericardiocentesis 25

56

IntracardiacIABP Echo Insertion 62

47 2.4%

Peripheral Diagnostic Procedures

Other-Diagnostic

1

Other-Noncoronary Inteventional IVUS-Intravascular Ultrasound

0.0% 1383

101

Congenital Diagnostic Procedures 11 Atherectomy/Rotoblator/Laser

KEY 443

49

IABP Insertion

47

Impella-Percutaneous VAD Thrombectomy 56 Other-Diagnostic

1

Other-Noncoronary Inteventional

3

STS Benchmark

Risk Adjusted Stroke

8 Flow Wire

Temporary Pacer Insertion

UCH

Structural Interventions 145

Coronary Interventions 266

1.3%

0.0%

15 Renal Risk Adjusted Failure 24

Risk Adjusted Prolonged

Congenital Intervention Procedures Ventilation

Peripheral Interventions 10101

8 49

Peripheral Interventions

Risk Adjusted Rates 451 Isolated CABG for

259

Temporary Pacer Insertion 4.3%

941

13

Transcatheter Aortic Valve Replacement (TAVR) 15 UCH Rate

Atherectomy/Rotoblator/Laser

TitlePost Procedure Inpatient Flow Wire Outcomes 24

Heart NationalLeft Rate

Impella-Percutaneous VAD

276 75%

13

Coronary Angiography Right Heart

Right Heart w/Vasodilator

Title

48

Biopsy

75% 63%

Angioplasty/Stent/Other PCI NSRT/Septal Ablation

7

4% 6%

Valvular Interventions 0% 2%

PFO/ASD/VSD Closures

Cardiac Stroke Mortality Pericardiocentesis 6% 1% 2% rate 4% Arrest 0% 2%

941

386

UCH Rate Right & Left Heart National Rate

5% 6%

1053

63%

11%

2% 1% 67

451

KEY

259

7%

67

Renal New Discharge to Failure permanent home Intracardiac Echo 62 (dialysis pacemaker pacemaker Mortality CardiacDiagnostic Stroke Procedures Renal New Discharge to Peripheral 443 dependent) rate Arrest Failure permanent home 5% 6%

11%

25 7%

National comparison from Outcomes Following Transcatheter Aortic Valve Replacement in the United States Peripheral Interventions (dialysis pacemaker 101 dependent) JAMA. 2013;310(19):2069-2077. IVUS-Intravascular doi:10.1001/jama.2013.282043 Ultrasound

Congenital Diagnostic Procedures

138

11

Title Intervention Procedures Congenital Title Temporary Pacer Insertion

8 49

56 Kansas City Cardiomyopathy Questionnaire Thrombectomy

IABP Insertion 47 Mean KCCQ Score of patients that participated in the KCCQ and had a TAVR procedure Other-Diagnostic 1 62.50 Other-Noncoronary Inteventional

3

Atherectomy/Rotoblator/Laser

82.00

82.00

62.50

15

Flow Wire

24

Impella-Percutaneous VAD

13

28.13

28.13

Title Mean Pre-TAVR KCCQ

UCH Rate National Rate

Mean 30 day TAVR follow up visit

Source: STS/ACC TVT Registry™

Mean Pre-TAVR KCCQ

75%

Mean 1 year TAVR follow up 63% visit

Mean 30 day TAVR follow up visit

Mean 1 year TAVR follow up visit

Clinical improvement in the KCCQ summary score: Moderately large improvement (≥ 10-point increase from baseline), Very large improvement (≥ 20-point increase from baseline), Favorable outcome (alive with ≥ 10-point increase from baseline), 11%

5% 6%

6%

4%≥ 20-point increase 1% 2% Excellent outcomes (alive with 0% 2% from baseline) Mortality rate

Cardiac Arrest

Stroke

7%

Renal New Discharge to Failure permanent home (dialysis pacemaker dependent)

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Cardiology Outcomes 2013 - University of Colorado Hospital  

University of Colorado Hospital cardiology outcomes data for 2013.

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