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1、EACTS Congenital Database 在中国的初步应用,首都医科大学附属北京安贞医院 小儿心脏外科 罗毅 李磊 吴永涛 2008-04-12 广东 广州,EACTS数据库形成的历史,ECHSF欧洲先心病外科医师基金会 1992 GOS Hospital London数据库 - M.Elliott 16.000 cases 1993-98 数据库迁到波兰华沙 - B.Maruszewski 2.500 cases 1998-99 EACTS洲心胸外科学会先心病数据库 2002-,数据库的理论基础1.命名系统,EACTS Franois Lacour-Gayet MD, Martin
2、 J. Elliott MD, Bohdan Maruszewski MD STS Constantine Mavroudis MD, Jeffrey P. Jacobs MD, C.Tchervenkov,欧洲先心病命名系统的历程（1993-1999）,15.000 topics Brompton codes 1993 荷兰 R.Franklin, J.Brower and M.Elliott 5.000 topics M.Elliott 1996 50个诊断 & 58种术式 1998 150 Diagnoses & 197 Procedures 1999 & 32 Complication
3、s - International Nomenclature Project EACTS & STS F.Lacour-Gayet, J.Stark, B.Maruszewski, C.Mavroudis, J.Jacobs, M.Jacobs, C.Tchervemkov,国际先心病命名系统历经多次会议讨论： Chicago, Illinois, September 19-20, 1998. San Antonio, Texas, January 23, 1999. Rome, Italy , April 10, 1999 New Orleans, Louisiana, April 23,
4、1999 Orlando, Florida, August 14-15, 1999 Glasgow, Scotland, September 5-8, 1999 Chicago, Illinois, October 1-2, 1999,International Congenital Heart Surgery Nomenclature and Database Project. - The Annals of Thoracic Surgery, 69:S1: 1-372, April 2000 Supplement .,“When there is no scientific answer
5、available; the opinion (doxa) perceived and admitted by the majority has the value of truth.” Aristotle, 350 BC,数据库的理论基础2.评分系统,来自21个国家的50名专家.涵盖EACTS, STS, ECHSF, CHSS,Torkel Aberg, Sweden Zohair Al-Halees, Saudi Arabia Vladimir Alexi-Meskishvili, Germany Hakan Berggren, Sweden Christian Brizard, Aus
6、tralia Bill Brawn, UK Kotuturathu Cherian, India Duccio Di Carlo, Italy Thierry Carrel, Switzerland Juan Comas, Spain Dave Clarke, USA Antonio F. Corno, Switzerland Giancarlo Crupi, Italy Willem Daenen, Belgium Sabine Daebritz, Germany Joseph Dearani, USA Roberto di Donato, Italy Tjark Ebels, Nether
7、lands Martin Elliot, UK William Gaynor, USA Siegfried Hagl, Germany Leslie Hamilton, UK Frank Hanley, USA Vladimir Ilyin, Russia Richard Jonas, USA,Marshall Jacobs, USA Guillermo Kreutzer, Argentina Garry Lofland, USA Franois Lacour-Gayet, France Harald Lindberg, Norway Bohdan Maruszewski, Poland Co
8、nstantine Mavroudis, USA Dominique Mtras, France Jim Monro, UK Marco Pozzi, UK Jean Rubay, Belgium Heikki Sairanen, Finland Shunzi Sanno, Japan Babulal Sethia, UK Aram K. Smolinsky, Israel Tom Spray, USA Giovanni Stellin, Italy Christo Tchervenkov, Canada Andreas Urban, Germany Careen Van Dorn, UK P
9、ascal Vouh, France Alfred E. Wood, Ireland Quing Yu Wu,China Lucio Zannini, Italy Gerhard Ziemer, Germany,The Aristotle Score: A Complexity-Adjusted Method to Evaluate Surgical Results. - The European Journal of Cardio-thoracic Surgery, 25(6):911-924, June 2004.,Simple 3 6 Average 6,5 9,Difficult 9,
10、5 12 Complex 12,5,Final Complexity Score (115),The Aristotle Score: A Complexity-Adjusted Method to Evaluate Surgical Results. The European Journal of Cardio-thoracic Surgery, 25(6):911-924, June 2004. International Congenital Heart Surgery Nomenclature and Database Project. The Annals of Thoracic S
11、urgery, 69:S1: 1-372, April 2000 Supplement .,设在波兰华沙 国际性数据库，通过互连网Internet工作 需要注册，免费使用,EACTS Congenital Database,EACTS Congenital Database,数据库主管 Bohdan Maruszewski M.D.,PhD Professor of Cardiothoracic Surgery Chairman EACTS Congenital Heart Committee email: bmarecdb.pl.pl 数据库管理员 Zdzislaw Tobota M.D.
12、email: ztobotaecdb.pl.pl Department of Pediatric Cardiothoracic Surgery The Childrens Memorial Health Institute, Warsaw, Poland,EACTS先心病委员会 Chair Pascal R. Vouhe Ex-officio Paul T. Sergeant Ex-officio Bruce E. Keogh Ex-officio Bohdan Maruszewski Member Juan V. Comas Member Rene Pretre Member Shunji
13、Sano Member George E. Sarris Member Christian Schreiber Member Lucio Valerio Zannini,统一先心病命名和复杂程度评分 数据库自动评定先心病复杂程度的计分 自动生成气泡图（The Bubble Chart） 自动生成质量评价报告 所有注册的中心、个人的数据都是匿名显示的 用于评价先心病医疗服务质量（个人、医院、国家）,EACTS先心病数据库的特点,CHINA 1. Cardiac surgery - Beijing anzhen hospital Beijing registration date: 25 Augu
14、st 2006 2. Cardiac Surgery - Hebei Province Childrens Hospital Shijiazhuang registration date: 18 June 2000 3. Pediatric Cardiac Surgery - Anzhen Hospital Beijing registration date: 19 September 2006 4. Pediatric Cardiac Center - Fuwai Cardiovascular Disease Hospital Beijing registration date: 18 Oc
15、tober 2004 5. Paediatric Cardiac Surgery - Xiangya 2nd hospital Changsha registration date: 8 May 2007 6. Department of Pediatric Cardiac Surgery - Shanxi Provincial Childrens Hospital Taiyuan registration date: 8 September 2000 7. cadiovascular surgery department - wuhan asia heart hospital wuhan r
16、egistration date: 8 December 2007 8. Department of Cardiac Surgery - Guangdong Cardiovascular Institute Guangzhou registration date: 17 October 2003 9. Department of Cardiothoracic Surgery - kow loon hospital,su zhou su zhou registration date: 6 September 2004 10. cardiothoracic surgery - NANJING CH
17、ILDRENS HOSPITAL NANJING CHINA registration date: 26 November 2007,There are less than 3 centers supplying data in China. The national report may be generated when at least 3 centers from your country supplied ,国家层面的质量评价,安贞医院小儿心脏外科2006年9月注册 2007年660例手术全部录入EACTS数据库 界面清晰；操作简便，易于掌握 录入数据量不大,EACTS先心病数据库的
18、应用实例,Database growth No of patients and Procedures,气泡图：以中心划分安贞小儿心脏2007年1-5月,气泡图：以中心划分安贞小儿心脏2007年全年,气泡图：以复杂程度难度等级划分,气泡图：以年龄划分婴儿（31-365 days）,气泡图：以年龄划分儿童 (1-18 years),气泡图：以术者划分,气泡图：以中心划分安贞小儿心脏2008年1-3月,The analysis of outcomes in health care is meant neither to threaten nor to punish the physicians or
19、 medical institutions It is a tool targeted on selfcontrol and improvement of the quality of care If we dont evaluate the outcomes of our work, this will be done by the others: Insurence companies Distributors of financial resources Media Lawyers,统一先心病命名命名系统 量化先心病复杂程度评分系统 用于评价先心病医疗服务质量,EACTS先心病数据库的意义,Thanks for your attention,