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General Thoracic Surgery Database Training Manual Version 2.41

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General Thoracic Surgery Database Training Manual Version 2.41 SEPTEMBER 4, 2020 Data Manager Quick Links New Data Warehouse - Starting January 1, 2020 – Important Information for ALL SITES! Database Transition Resources STS National Database Webinars Data Manager Education Data Collection Resources (version specific abstraction documents) Ask an Abstraction Question STS National Database News - Publication for STS Data Managers Public Reporting Contact Information GENERAL THORACIC SURGERY DATABASE TRAINING MANUAL VERSION 2.41 General Thoracic Surgery Database V2.41 Training Manual September 4, 2020 Table of Contents Case Examples ............................................................................................................................................................3 Definitions ..................................................................................................................................................................4 Risk Model ..................................................................................................................................................................4 Demographics .............................................................................................................................................................5 Admission ................................................................................................................................................................ 13 Pre-Operative Evaluation ........................................................................................................................................ 18 Diagnosis (Category of Disease) .............................................................................................................................. 56 Operative ................................................................................................................................................................. 79 Lung Cancer ............................................................................................................................................................ 122 Esophageal Cancer .................................................................................................................................................. 152 Thymus/Mediastinal Mass Resection ....................................................................................................................... 165 Tracheal Resection .................................................................................................................................................. 177 Hiatal Hernia / GERD ............................................................................................................................................... 190 Disposition .............................................................................................................................................................. 213 Post – Operative Events .......................................................................................................................................... 215 Discharge ................................................................................................................................................................ 255 Follow Up................................................................................................................................................................ 262 Quality Measures .................................................................................................................................................... 263 Resources .............................................................................................................................................................. 269 2 | P a g e General Thoracic Surgery Database V2.41 Training Manual September 4, 2020 Case Examples The STS General Thoracic Registry version 2.41 requires submission of all lung resections for primary lung cancer and all esophageal resections for primary esophageal cancer. Lung and esophageal resections for primary cancer are analyzed including national outcomes for benchmarking, risk adjusted outcomes, and star rating. Participants in the General Thoracic Registry may choose to submit Thymus/Mediastinal Mass Resection, Tracheal Resection, and Hiatal Hernia/GERD cases. These case types are optional modules for submission to the registry and will be analyzed in the national report if submitted. All other case types are not required for collection or submission. They will not be analyzed in the aggregate report if submitted. Case #1: Patient has nodule on CT scan and is also worked up with a PET scan. Surgeon thinks it could be cancer so lung resection is completed and path comes back as lung cancer. This case is required for the registry. Enter this case as a lobectomy for primary lung cancer including the clinical and path staging. Case #2: Same as above but path comes back as hamartoma. This case is not required for submission to the registry because resection ultimately was not for primary lung cancer. This case will not be analyzed if submitted. Case #3 Patient worked up for presumed lung cancer and taken to OR for planned wedge resection followed by lobectomy if frozen section shows cancer. Frozen section comes back as granuloma so surgery ends at wedge resection. This case is not required for submission because resection ultimately was not for lung cancer. This case would not be analyzed if submitted. Case #4 Patient presents to hospital with pneumonia. CT shows necrotic fluid suspicious for lung abscess in LLL. Patient taken to OR to drain effusion and wedge resection of abscess. Completion lobectomy was then undertaken because the lung was not salvageable. There was never suspected cancer. This case is not required for submission because resection ultimately was not for lung cancer. This case would not be analyzed if submitted. Case #5 Patient with history of breast cancer and previous mets to the lung removed via wedge and presents now with a new nodule. Surgeon assumes it’s another met. Taken to OR for therapeutic wedge resection. Final pathology returns as early stage primary lung cancer. This case is required for the registry. Enter this case as a wedge resection for primary lung cancer including the clinical and pathological staging. This case will be analyzed. Case #6 Patient presents with empyema and undergoes decortication. This case is not required for submission to the registry because it is not a lung resection for primary lung cancer. This case will not be analyzed if submitted. 3 | P a g e General Thoracic Surgery Database V2.41 Training Manual September 4, 2020 Case #7 Patient presents with mediastinal mass. Ultimately undergoes thymectomy. Pathology returns with stage II thymoma. This case is an optional submission using the Thymus/Mediastinal Mass module. This case will be analyzed if submitted. Definitions “No” should be indicated if there is documentation that the patient does not have Pulmonary Hypertension. “Unknown” should be indicated if it is not known if the patient has Pulmonary Hypertension or if testing has not been performed. Risk Model The risk model is an all or none model. Within the risk model complications are not tallied or delineated. The patient either has complications or they do not. Therefore, all complications / post-operative events are to be captured. 4 | P a g e General Thoracic Surgery Database V2.41 Training Manual September 4, 2020 Demographics SeqNo: 10 Long Name: Operations Table Record Identifier Short Name: RecordID Definition: An arbitrary, unique value generated by the software that permanently identifies each record in the participant's database (note that unlike the PatID value, this does not identify the individual patient). The value of the identifier is a combination of a code assigned to the software developer by the STS, and a value generated by the software to create a unique value. Once assigned to a record, this value can never be changed or reused. The data warehouse will use this value to communicate issues about individual records with the participant. It may also be used by the data warehouse to link this record to other clinical data. Intent/Clarification: A record should be initiated for inpatient and outpatient thoracic procedures on every visit to the operating room (includes Endoscopy Suite or Outpatient Surgical Center) whether planned or unplanned. SeqNo: 20 Long Name: Procedures Table Record Identifier Short Name: RecordID Definition: This field is the foreign key that links this record with the associated records in the "Operations" table. SeqNo: 30 Long Name: Software Vendor's Identification Short Name: VendorID Definition: Software vendor's identification assigned by the STS. SeqNo: 40 Long Name: Vendor's Software Version Number Short Name: SoftVrsn Definition: Vendor's software product version number identifying the software which created this record. Vendor controls the value in this field. Version passing certification/harvest testing will be noted at the data warehouse. SeqNo: 50 Long Name: Version Of STS Data Specification Short Name: DataVrsn Definition: Version number of the STS Data Specifications/Dictionary, to which the record conforms. The value will identify which fields should have data, and what are the valid data values for those fields. It must 5 | P a g e General Thoracic Surgery Database V2.41 Training Manual September 4, 2020 be the version implemented in the software at the time the
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