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Application of the Boston Technical Performance Score to intraoperative echocardiography

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Application of the Boston Technical Performance Score to intraoperative echocardiography. / Bellsham-Revell, Hannah R.; Deri, Antigoni; Caroli, Silvia et al.

In: Echo Research and Practice, Vol. 6, No. 3, 2019, p. 63-70.

Research output: Contribution to journalArticlepeer-review

Harvard

Bellsham-Revell, HR, Deri, A, Caroli, S, Durward, A, Miller, OI, Mathur, S, Saundankar, J, Anderson, DR, Conal Austin, B, Salih, C, Pushparajah, K & Simpson, JM 2019, 'Application of the Boston Technical Performance Score to intraoperative echocardiography', Echo Research and Practice, vol. 6, no. 3, pp. 63-70. https://doi.org/10.1530/ERP-19-0032

APA

Bellsham-Revell, H. R., Deri, A., Caroli, S., Durward, A., Miller, O. I., Mathur, S., Saundankar, J., Anderson, D. R., Conal Austin, B., Salih, C., Pushparajah, K., & Simpson, J. M. (2019). Application of the Boston Technical Performance Score to intraoperative echocardiography. Echo Research and Practice, 6(3), 63-70. https://doi.org/10.1530/ERP-19-0032

Vancouver

Bellsham-Revell HR, Deri A, Caroli S, Durward A, Miller OI, Mathur S et al. Application of the Boston Technical Performance Score to intraoperative echocardiography. Echo Research and Practice. 2019;6(3):63-70. https://doi.org/10.1530/ERP-19-0032

Author

Bellsham-Revell, Hannah R. ; Deri, Antigoni ; Caroli, Silvia et al. / Application of the Boston Technical Performance Score to intraoperative echocardiography. In: Echo Research and Practice. 2019 ; Vol. 6, No. 3. pp. 63-70.

Bibtex Download

@article{eb2062dc32594586ae2d1d5f47a05375,
title = "Application of the Boston Technical Performance Score to intraoperative echocardiography",
abstract = "Background: The Technical Performance Score (TPS) developed by Boston Children's Hospital showed surgical outcomes correlate with adequacy of technical repair when implemented on pre-discharge echocardiograms. We applied this scoring system to intraoperative imaging in a tertiary UK congenital heart surgical centre. Methods: After a period of training, intraoperative TPS (epicardial and/or transesophageal echocardiography) was instituted. TPS was used to inform intraoperative discussions and recorded on a custom-made database using the previously published scoring system. After a year, we reviewed the feasibility, results and relationship between the TPS and mortality, extubation time and length of stay. Results: From 01 September 2015 to 04 July 2016, there were 272 TPS procedures in 251 operations with 208 TPS recorded. Seven patients had surgery with no documented TPS, three had operations with no current TPS score template available. Patients left the operating theatre with TPS optimal in 156 (75%), adequate 34 (16%) and inadequate 18 (9%). Of those with an optimal score on leaving theatre, ten had more than one period of cardiopulmonary bypass. All four deaths <30 days after surgery (1.9%) had optimal TPS. There was a statistically significant difference in extubation times in the RACHS category 4 patients (3 days vs 5 days, P < 0.05) and in PICU and total length of stay in the RACHS category three patients (2 and 8 days vs 12.5 and 21.5 days respectively) if leaving theatre with an inadequate result. Conclusions: Application of intraoperative TPS is feasible and provides a way of objectively recording intraoperative imaging assessment of surgery. An 'inadequate' TPS did not predict mortality but correlated with a longer ventilation time and longer length of stay compared to those with optimal or adequate scores.",
keywords = "C ent ca.com, Congenital heart disease, Intraoperative echocardiography, Surgery",
author = "Bellsham-Revell, {Hannah R.} and Antigoni Deri and Silvia Caroli and Andrew Durward and Miller, {Owen I.} and Sujeev Mathur and Jelena Saundankar and Anderson, {David R.} and {Conal Austin}, B. and Caner Salih and Kuberan Pushparajah and Simpson, {John M.}",
year = "2019",
doi = "10.1530/ERP-19-0032",
language = "English",
volume = "6",
pages = "63--70",
journal = "Echo Research and Practice",
issn = "2055-0464",
publisher = "BioScientifica Ltd.",
number = "3",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Application of the Boston Technical Performance Score to intraoperative echocardiography

AU - Bellsham-Revell, Hannah R.

AU - Deri, Antigoni

AU - Caroli, Silvia

AU - Durward, Andrew

AU - Miller, Owen I.

AU - Mathur, Sujeev

AU - Saundankar, Jelena

AU - Anderson, David R.

AU - Conal Austin, B.

AU - Salih, Caner

AU - Pushparajah, Kuberan

AU - Simpson, John M.

PY - 2019

Y1 - 2019

N2 - Background: The Technical Performance Score (TPS) developed by Boston Children's Hospital showed surgical outcomes correlate with adequacy of technical repair when implemented on pre-discharge echocardiograms. We applied this scoring system to intraoperative imaging in a tertiary UK congenital heart surgical centre. Methods: After a period of training, intraoperative TPS (epicardial and/or transesophageal echocardiography) was instituted. TPS was used to inform intraoperative discussions and recorded on a custom-made database using the previously published scoring system. After a year, we reviewed the feasibility, results and relationship between the TPS and mortality, extubation time and length of stay. Results: From 01 September 2015 to 04 July 2016, there were 272 TPS procedures in 251 operations with 208 TPS recorded. Seven patients had surgery with no documented TPS, three had operations with no current TPS score template available. Patients left the operating theatre with TPS optimal in 156 (75%), adequate 34 (16%) and inadequate 18 (9%). Of those with an optimal score on leaving theatre, ten had more than one period of cardiopulmonary bypass. All four deaths <30 days after surgery (1.9%) had optimal TPS. There was a statistically significant difference in extubation times in the RACHS category 4 patients (3 days vs 5 days, P < 0.05) and in PICU and total length of stay in the RACHS category three patients (2 and 8 days vs 12.5 and 21.5 days respectively) if leaving theatre with an inadequate result. Conclusions: Application of intraoperative TPS is feasible and provides a way of objectively recording intraoperative imaging assessment of surgery. An 'inadequate' TPS did not predict mortality but correlated with a longer ventilation time and longer length of stay compared to those with optimal or adequate scores.

AB - Background: The Technical Performance Score (TPS) developed by Boston Children's Hospital showed surgical outcomes correlate with adequacy of technical repair when implemented on pre-discharge echocardiograms. We applied this scoring system to intraoperative imaging in a tertiary UK congenital heart surgical centre. Methods: After a period of training, intraoperative TPS (epicardial and/or transesophageal echocardiography) was instituted. TPS was used to inform intraoperative discussions and recorded on a custom-made database using the previously published scoring system. After a year, we reviewed the feasibility, results and relationship between the TPS and mortality, extubation time and length of stay. Results: From 01 September 2015 to 04 July 2016, there were 272 TPS procedures in 251 operations with 208 TPS recorded. Seven patients had surgery with no documented TPS, three had operations with no current TPS score template available. Patients left the operating theatre with TPS optimal in 156 (75%), adequate 34 (16%) and inadequate 18 (9%). Of those with an optimal score on leaving theatre, ten had more than one period of cardiopulmonary bypass. All four deaths <30 days after surgery (1.9%) had optimal TPS. There was a statistically significant difference in extubation times in the RACHS category 4 patients (3 days vs 5 days, P < 0.05) and in PICU and total length of stay in the RACHS category three patients (2 and 8 days vs 12.5 and 21.5 days respectively) if leaving theatre with an inadequate result. Conclusions: Application of intraoperative TPS is feasible and provides a way of objectively recording intraoperative imaging assessment of surgery. An 'inadequate' TPS did not predict mortality but correlated with a longer ventilation time and longer length of stay compared to those with optimal or adequate scores.

KW - C ent ca.com

KW - Congenital heart disease

KW - Intraoperative echocardiography

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=85070616313&partnerID=8YFLogxK

U2 - 10.1530/ERP-19-0032

DO - 10.1530/ERP-19-0032

M3 - Article

AN - SCOPUS:85070616313

VL - 6

SP - 63

EP - 70

JO - Echo Research and Practice

JF - Echo Research and Practice

SN - 2055-0464

IS - 3

ER -

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