Description of a Method to Obtain Complete One-Year Follow-Up in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry

• Published in: The American journal of cardiology 2018-03, Vol.121 (6), p.758-761
• Main Authors: Wooley, Jordan, Neatherlin, Holly, Mahoney, Cecile, Squiers, John J., Tabachnick, Deborah, Suresh, Mitta, Huff, Eleanor, Basra, Sukhdeep S., DiMaio, J. Michael, Brown, David L., Mack, Michael J., Holper, Elizabeth M.
• Format: Article
• Language: English
• Subjects: Aortic valve; Cardiology; Clinical outcomes; Collaboration; Data warehouses; Government programs; Health care; Implantation; Medicaid; Medical personnel; Medical records; Mortality; Patients; Physicians; Quality; Surgeons; Survival; Telephone calls; Thorax
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.11.046

The Centers for Medicare and Medicaid Services National Coverage Determination requires centers performing transcatheter aortic valve implantation (TAVI) to report clinical outcomes up to 1 year. Many sites encounter challenges in obtaining complete 1-year follow-up. We report our process to address this challenge. A multidisciplinary process involving clinical personnel, data and quality managers, and research coordinators was initiated to collect TAVI data at baseline, 30 days, and 1 year. This process included (1) planned clinical follow-up of all patients at 30 days and 1 year; (2) query of health-care system-wide integrated data warehouse (IDW) to ascertain last date of clinical contact within the system for all patients; (3) online obituary search, cross-referencing for unique patient identifiers to determine if mortality occurred in remaining unknown patients; and (4) phone calls to remaining unknown patients or patients' families. Between January 2012 and December 2016, 744 patients underwent TAVI. All 744 patients were eligible for 30-day follow-up and 546 were eligible for 1-year follow-up. At routine clinical follow-up of 22 of 744 (3%) patients at 30 days and 180 of 546 (33%) patients at 1 year had unknown survival status. The integrated data warehouse query confirmed status-alive for an additional 1 of 22 patients at 30 days (55%) and 91 of 180 patients at 1 year (51%). Obituaries were identified for 23 of 180 additional patients at 1 year (13%). Phone contact identified the remaining unknown patients at 30 days and 1 year, resulting in 100% known survival status for patients at 30 days (744 of 744) and at 1 year (546 of 546). In conclusion, using a comprehensive approach, we were able to determine survival status in 100% of patients who underwent TAVI.