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      Criação e implementação de um banco de dados cirúrgico totalmente informatizado baseado nas ferramentas Google: experiência inicial em cirurgia cardiovascular. Translated title: Design and implementation of a fully electronic surgery database based on Google tools: an initial experience in cardiovascular surgery.

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          Abstract

          RESUMO Objetivo: descrever de maneira prática e detalhada a criação de uma plataforma totalmente informatizada para coleta, armazenamento e análise de dados, inicialmente proposta para cirurgia cardiovascular, com interfaces reprodutíveis e aplicáveis a outras especialidades cirúrgicas, bem como, apresentar a experiência inicial de trabalho com esta ferramenta e os resultados preliminares obtidos após sua implementação em um hospital universitário terciário brasileiro. Métodos: a plataforma foi desenvolvida com base nas ferramentas Google, gratuitas, de fácil utilização e amplamente acessíveis. Desde o início desta iniciativa, em maio de 2015, até a análise preliminar, em fevereiro de 2017, dados de 271 pacientes, consecutivos, submetidos à cirurgia cardiovascular foram prospectivamente recordados e analisados. Resultados: a iniciativa foi implementada com pleno sucesso, com 100% dos pacientes incluídos e sem perda de qualquer variável em um banco de dados composto por mais de 500 variáveis. As complicações pós-operatórias imediatas mais frequentes foram: fibrilação atrial (22,5%), broncopneumonia (10,7%), delirium (10,3%), insuficiência renal aguda (10%), acidente vascular encefálico (5%) e morte (7%). Comparando-se as taxas de mortalidade no primeiro e segundo anos da iniciativa, uma redução de 10,8% para 4% (p=0,042), respectivamente, foi evidenciada. Conclusão: a nova proposta de coleta e armazenamento de dados apresentada neste trabalho mostrou-se plenamente factível e efetiva. Por serem gratuitas, de fácil manuseio e universalmente acessíveis, estas ferramentas podem ser úteis a outras especialidades cirúrgicas que desejem desenvolver métodos de avaliação de sucesso e complicações pós-operatórios, bem como, programas de melhoria de qualidade.

          Translated abstract

          ABSTRACT Objective: to describe, in a practical and step-by-step manner, the construction of a fully electronic platform for data collection, storage, and analysis, initially proposed for cardiovascular surgery, with interfaces that are reproducible and applicable to other surgical specialties, as well as to present the initial work experience with this instrument in cardiac surgery and the preliminary results obtained after its implementation in a Brazilian tertiary university hospital. Methods: the platform was developed based on Google tools, which are free, easy to use, and widely accessible. From the beginning of this initiative, in May 2015, to the preliminary analysis, in February 2017, data from 271 consecutive patients submitted to cardiovascular surgery were prospectively recorded and preliminarily analyzed. Results: the initiative was implemented with full success, with 100% of patients included and without loss of any variable, in a database composed of more than 500 variables. The most frequent immediate postoperative complications were: atrial fibrillation (22.5%), bronchopneumonia (10.7%), delirium (10.3%), acute renal failure (10%), stroke (5%), and death (7%). Comparing mortality rates in the first and second years of the initiative, a reduction from 10.8% to 4% (p=0.042), respectively, was evidenced. Conclusion: the new proposal of data collection and storage presented in this work was fully feasible and effective. It may be useful to other surgical specialties that wish to develop methods to evaluate success and postoperative complication rates, as well as quality improvement programs.

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          Most cited references 10

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          Improved Surgical Outcomes for ACS NSQIP Hospitals Over Time: Evaluation of Hospital Cohorts With up to 8 Years of Participation.

          The American College of Surgeons, National Surgical Quality Improvement Program (ACS NSQIP) surgical quality feedback models are recalibrated every 6 months, and each hospital is given risk-adjusted, hierarchical model, odds ratios that permit comparison to an estimated average NSQIP hospital at a particular point in time. This approach is appropriate for "relative" benchmarking, and for targeting quality improvement efforts, but does not permit evaluation of hospital or program-wide changes in quality over time. We report on long-term improvement in surgical outcomes associated with participation in ACS NSQIP.
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            The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2017 Update on Outcomes and Quality.

            Established in 1989, The Society of Thoracic Surgeons Adult Cardiac Surgery Database is one of the most comprehensive clinical data registries in health care. It is widely regarded as the gold standard for benchmarking risk-adjusted outcomes in cardiac surgery and is the foundation for all quality measurement and improvement activities of The Society of Thoracic Surgeons. This is the second in a series of annual reports that summarizes current aggregate national outcomes in cardiac surgery and reviews database-related activities in the areas of quality measurement and performance improvement during the past year.
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              Quality improvement program decreases mortality after cardiac surgery.

              This study investigated the effects of a quality improvement program and goal-oriented, multidisciplinary protocols on mortality after cardiac surgery.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rcbc
                Revista do Colégio Brasileiro de Cirurgiões
                Rev. Col. Bras. Cir.
                Colégio Brasileiro de Cirurgiões (Rio de Janeiro, RJ, Brazil )
                0100-6991
                1809-4546
                May 2019
                : 46
                : 2
                Affiliations
                Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Faculdade de Medicina Brazil
                Porto Alegre RS orgnameHospital de Clínicas de Porto Alegre orgdiv1Serviço de Cirurgia Cardiovascular Brasil
                Porto Alegre RS orgnameHospital de Clínicas de Porto Alegre orgdiv1Serviço de Cirurgia Geral Brasil
                Article
                S0100-69912019000200155
                10.1590/0100-6991e-20192123

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 0
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