Table 3.
Recommended measures to assess quality of results in clinical practice
| Metric | Suggested reference value | Relevance | Difficulty | Auditable | Evidence | References |
|---|---|---|---|---|---|---|
| Mortality a | ||||||
| STEMI mortality (excluding Killip IV class patients and patients after cardiopulmonary resuscitation) | <5% (a) | 1 | 1 | 1 | A | 41,42 |
| Non-STE-ACS mortality (excluding Killip IV class patients and patients after cardiopulmonary resuscitation) | <3% (a) | 1 | 1 | 1 | A | 43,44 |
| Staged PCI mortality | <1% (a) | 1 | 1 | 1 | A | 56 |
| TAVI mortality | <6% (a) | 1 | 1 | 1 | A | 57,58 |
| VT after AMI and other complex catheter ablation mortality | <3% (a) | 1 | 1 | 1 | A | 59–61 |
| Pacemaker, ICD, CRT implant mortality | <1% (a) | 1 | 1 | 1 | A | 62,63 |
| Heart failure mortality | <7% (a) | 1 | 1 | 1 | A | 67 |
| Staged first aortic valve surgery replacement mortality (excluding TAVI) | <5% (a) <7% (b) |
1 | 1 | 1 | A | 64–66 |
| Staged first mitral valve surgery replacement mortality | <7% (a) <9% (b) |
1 | 1 | 1 | A | 64–66 |
| Staged first mitral valve surgery repair mortality | <3% (a) <5% (b) |
1 | 1 | 1 | A | 64–66 |
| Staged first CABG (without combined surgery) mortality | <3% (a) <5% (b) |
1 | 1 | 1 | A | 64–66 |
| Staged first combined CABG + AVR mortality | <6% (a) <8% (b) |
1 | 1 | 1 | A | 64–66 |
| Heart transplant | <15% (a)(c) | 1 | 1 | 1 | A | 184 |
| Hospitalization b | ||||||
| STEMI number of days in hospital | <10 | 2 | 2 | 1 | A | 41,42 |
| Non-STE-ACS number of days in hospital | <10 | 2 | 2 | 1 | A | 43,44 |
| Heart failure number of days in hospital | <9 | 2 | 2 | 1 | A | 5,11,18,67 |
| Staged first CABG, aortic or mitral surgery number of days in hospital | <15 | 2 | 2 | 1 | A | 64,68,69 |
| Rehospitalization after ACS, heart failure, or surgery as abovec | Less than mean value in national registries | |||||
Reference values are orientative. For benchmarking, a target reference value less than median value in participating hospitals is strongly suggested.
aMortality: 30 days all-cause mortality is preferred over mortality before hospital discharge only if reliable data can be obtained.
b Hospitalization: the number of days in any hospital during the first 30 days after index hospitalization is preferred over number of days from hospitalization to discharge.
c Rehospitalization: unplanned readmission for any cause to any acute care hospital within 30 days of discharge from a hospitalization. (a) Observed mortality (mean value). (b) Expected mortality corrected for the logistic euroscore for this population. (c) Mortality or re-transplant. CABG, coronary artery bypass-grafting; TAVI, transaortic valve implant.