HomeInformation about NHISNational Health RegistersNational Register of Cardiovascular Surgery and Interventions (NRKOI)

National Register of Cardiac Surgery (NKCHR)

PURPOSE OF DETECTION OF REQUESTED DATA

The purpose of detection of requested data is establishment of a nationwide central health register of persons with serious heart diseases who underwent heart surgery.

NKCHR is the continuation of the National register of cardiovascular interventions that had been maintained since 1997 by the Centre MEDICON - IKEM. N NKCHR was established in 2002 in order to satisfy the needs of all participating cardiac surgery facilities to obtain information in the numbers on heart surgery operations performed in the individual centres and to facilitate more precise evaluation and analysis of quality of the performances including mortality, length of hospitalisation and stratification of the risk factors.

The register includes processed personal data necessary for identification of the patient, data connected with the status of the patient in relation to he disease – preoperative information (cardiac anamnesis, previous interventions, changes hazardous for development of IHD, cardiac examination and preoperative status and support incl. reason of present operation), operative information (date of operation, age at time of operation, identification of the surgeon, specific medical information on the operation performed) and post-operative information (specific medical information on the patient’s stay in intensive care unit of the health establishment, post-operative complications, on discharge from health establishment or on death of the patient). The register also contains data necessary for identification of the health establishment in which cardiac surgery was performed.

RANGE OF DATA PROVIDED BY HEALTH ESTABLISHMENTS TO NKCHR

Since the end of 2003, NKCHR is operated as a web application with central database. The commissioned NKCHR workplace inserts data to the register by means of internet connection via secure https protocol. Access to the register and assignment of user roles is authorised by the administrator of the register.

A. Pre-operative information

  • Identification of workplace
    – name of  workplace
    – code of workplace
  • Personal data of the patient
    – Personal Identification number
    – name (not entered)
    – Surname (not entered)
    – date of  birth
    – sex
    – height
    – weight
    – BMI
  • Admission for hospitalisation
    – date of admission
    – number of medical record (local code of the case)
    – place of residence (municipality)
  • Cardial anamnesis
    – angina pectoris before operation (CCS classification)
    – dyspnoea before operation
    – number of previous myocardial infarctions in anamnesis
    – interval between operation and the last MI
    – heart failure in anamnesis
  • previous interventions 
    – previous PCI
    – date of the last PCI
    – previous, vascular or thoracic heart surgery
    – date of the last heart surgery
    – number of previous heart surgeries
  • Changes hazardous for development of IHD
    – tobacco abuse
    – therapy of diabetes mellitus
    – anamnesis of hypertension
    – dysplaidemia – renal disease
    – last preoperative serum creatinine
    – anamnesis of lung disease
    – anamnesis of neurological disease
    – anamnesis of neurological dysfunction
    – significant infliction of arteries supplying brain
    – disease (infliction) of peripheral arteries
    – preoperative cardiac rhythm
    – other additional diseases or complications
  • Cardiac examination
    – left-sided or right-sided cardiac cathetrisation
    – date of last cathetrisation
    – number of inflicted coronary arteries
    – infliction of left coronary artery stem
    – systolic pressure in a pulmonalis
    – LVEDP
    –mean PAWP/LA value
    – ejection fraction
    – category of ejection fraction
    –mean gradient on aortic valve
    – aortic stenosis
    – mitral stenosis
    – insufficiency of aortic valve
    – insufficiency of mitral valve
    – insufficiency of tricuspid valve
  • Pre-operative status and support
    – intravenous nitrates or any heparin before operation
    – intravenous inotropic substances before operation
    – other pre-operative medication during 1 week before operation
    – hemodynamic status before operation
    – cardiogenic shock before operation
    – cardiopulmonary resuscitation < 24 hours before operation
    – artificial lung ventilation before operation
    – reason for present operation
    – examining physician

B. Operative information

  • Beginning of operation
    – date and time of beginning of operation
    – age at time of operation
    – surgeon
    – operative approach
    – type of operation
    – main reason for urgent operation
  • Aortocoronary bypass 
    – number of performed peripheral anastomoses by arterial grafts
    – number of performed peripheral anastomoses by vein grafts
    – total number of performed peripheral anastomoses
    –location of performed peripheral anastomoses
    – used graft
  • operations on valves
    – operation on aortic valve
    – operation on mitral valve
    – operation on tricuspid valve
    – operation on pulmonary valve
    – number of valves on which operation was performed
  • Other performed interventions
    – other cardiosurgery interventions
    – other interventions
    – segment of aorta
    – operation performed on aorta
    – kind of operation
  • Extracorporeal circulation and myocardial protection
    – extracorporeal circulation
    – use of  clamp
    – circulatory arrest duration of EC
    – total duration of clamp
    – total duration of circulatory arrest
    – myocardial protection in use of EC
    – cardioplegia – solution
    – cardioplegia – temperature
    – cardioplegia – method of application
    – cardioplegia – form of application
    – myocardial protection without cardioplegia
    – intraaortic balloon counterpulsation
    – reason of IABC
    – mechanical heart support
    – mechanical heart support - time

C. Post-operative information 

  • Stay in ICU
    – blood derivatives applied
    – number of blood derivative units
    – total blood loss
    – stay in ICU
  • – admission date and time in ICU
    – date and time of extubation
    – reintubation
    – total duration of intubation
    – therapy in ICU
    – date and time of discharge from ICU
    – duration of stay in ICU
  • Post-operative complications
    – post-operative revisions
    – renal complications
    – neurological complications
    – other neurological complications
    – early complications and infection
    – other complications
    – multiorgan failure
    – myocardial ischemia
  • Discharge/exitus
    – status of patient at discharge from health establishment
    – date and time of discharge (exitus) from health establishment
    – duration of hospitalisation
    – duration from operation to discharge
    – discharged into
    – place of exitus
    – primary cause of death
    – date of exitus
    – status
    – remarks
    – discharging physician
    – date of completion and closing this form

STATISTICAL UNIT OF INVESTIGATION

A statistical unit is a performed cardiac surgery.