Cardiac Center Surgery Survival Rates by Complexity of Procedure
Data here is arranged by complexity of procedure. Surgical procedures are placed in categories from 1 to 6. This system is called Risk Adjustment for Congenital Heart Surgery (RACHS-1). The Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database calculates the RACHS-1 mortality rate in each category for each hospital, and also provides us an expert consensus source to compare data across heart centers. For more information about the RACHS-1 system, read below.
Pediatric heart surgery survival rates reflect the number of patients who survived within 30 days of the surgery or until the time they were discharged, whichever period is longer.
These charts show volume and outcomes for RACHS-1 procedures at The Children’s Hospital of Philadelphia.
RACHS-1: Category 1
Procedures in Category 1 are the least complex.
| Year | Survived Died |
|---|---|
| 2007 | 571 |
| 2008 | 711 |
| 2009 | 671 |
| 2010 | 58 |
RACHS-1: Category 2
| Year | Survived Died |
|---|---|
| 2007 | 2023 |
| 2008 | 2014 |
| 2009 | 1832 |
| 2010 | 1711 |
RACHS-1: Category 3
| Year | Survived Died |
|---|---|
| 2007 | 1503 |
| 2008 | 1728 |
| 2009 | 1554 |
| 2010 | 1744 |
RACHS-1: Category 4
| Year | Survived Died |
|---|---|
| 2007 | 422 |
| 2008 | 411 |
| 2009 | 483 |
| 2010 | 395 |
RACHS-1: Category 5-6
Procedures in categories 5 and 6 are the most complex.
| Year | Survived Died |
|---|---|
| 2007 | 492 |
| 2008 | 436 |
| 2009 | 215 |
| 2010 | 396 |
More information about RACHS-1
What do CHOP’s RACHS-1 scores show?
Our mortality rates in all RACHS-1 categories are very good. They confirm that while our surgeons operate on many patients with extremely complex heart defects, mortality rates are low. In other words, we treat the sickest children and very few of them die.
What is RACHS-1?
RACHS-1 is a system that places surgical procedures into categories based on complexity. The system allows hospitals to track and compare clinical outcomes (how patients did after surgery) in each category.
Procedures are assigned a RACHS-1 category from 1 to 6. Here are a few examples: closure of an atrial septal defect is a 1; the arterial switch operation is a 3; and the Norwood procedure is a 6. A group of surgeons and other experts decides which procedures go into which categories. View a list of RACHS-1 procedures.
Why is RACHS-1 necessary?
The system was created so outcomes can be compared from hospital to hospital. Suppose Hospital A does many surgeries that are less complex. Suppose Hospital B does many surgeries that are very complex, on the sickest patients. Hospital A might show a better overall mortality rate than Hospital B. That would not necessarily mean that Hospital A is a better choice for surgery. In fact, the most skilled, experienced surgeons might be at Hospital B.
RACHS-1 allows meaningful comparison between hospitals based on the complexity of surgeries they are doing.
How are RACHS-1 scores generated?
There are 207 different procedures in the RACHS-1 classification system. Not every procedure is included.
Our surgeons record data about every RACHS-1 procedure into a database, including information about each patient before, during and after surgery. CHOP sends the data to the Society of Thoracic Surgeons, an independent nonprofit organization representing surgeons worldwide. The Society gives CHOP its official RACHS-1 scores. After we receive our scores, we review and compare our clinical outcomes to those of other hospitals.
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