Surgical Quality Predicts Length of Stay in XXXX with @entity299 .

@entity1 @entity548 @entity1764 @entity299 @entity912 @entity616
UNASSIGNED: Historically, the primary marker of quality for congenital cardiac surgery has been postoperative mortality. The purpose of this study was to determine whether additional markers (10 surgical metrics) independently predict length of stay (LOS), thereby providing specific targets for quality improvement. Ten metrics (unplanned ECMO, unplanned cardiac catheterization, revision of primary repair, delayed closure, @entity1764 , reexploration for @entity548 , complete @entity616 , vocal @entity912 , @entity912 , and change in preoperative diagnosis) were defined in 2008 and subsequently collected from 1024 consecutive index congenital cardiac cases, yielding 990 cases. Four @entity1 characteristics and 22 case characteristics were used for risk adjustment. Univariate and multivariable analyses were used to determine independent associations between each metric and postoperative LOS. Increased LOS was independently associated with revision of the primary repair (p  =  0.014), @entity616 requiring a permanent pacemaker (p  =  0.001), @entity912 requiring plication (p  <  0.001), and unplanned postoperative cardiac catheterization (p  <  0.001). Compared with @entity1 without each metric, LOS was 1.6 (95  % CI 1.1-2.2, p  =  0.014), 1.7 (95  % CI 1.2-2.3, p  =  0.001), 1.8 (95  % CI 1.4-2.3, p  <  0.001), and 2.0 (95  % CI 1.7-2.4, p  <  0.001) times as long, respectively. These effects equated to an additional 4.5-7.8  days in hospital, depending on the metric. The other 6 metrics were not independently associated with increased LOS. The quality of surgery during repair of @entity299 affects outcomes. Reducing the incidence of these 4 specific surgical metrics may significantly decrease LOS in this population.
