ArticleJournal of the American College of Cardiology2022
Risk Stratification for Congenital Heart Surgery for ICD-10 Administrative Data (RACHS-2).
Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed.
- Opioid and Methadone Prescribing for Infants with Surgical Management of Congenital Heart Disease.Pediatric cardiology · 2026Observational
- Article
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- PORT: Generative EHR Pretraining for Pediatric Intraoperative Risk Prediction.Research square · 2026Article
- Managing cyanotic neonates with tetralogy of Fallot: A national perspective on surgical approaches.JTCVS open · 2026Article
- Congenital heart diseases involving congenitally diseased pulmonary valve phenotypes: Novel insights into the health care burden across the life course.JTCVS open · 2026Article
- Medical Travel and Geographic Inequities in Access to Pediatric Congenital Heart Surgery: Evidence from a Nationwide Cohort in South Korea.Pediatric cardiology · 2026Article
- Public Reporting and Case Selection in Congenital Heart Surgery: Signals From a Multicenter Observational Study.Journal of the American College of Cardiology · 2026Observational
- The Case for the Pediatric Cardiologist-Informaticist.Pediatric cardiology · 2026Review
- Inpatient hospitalizations in adults with congenital heart disease and down syndrome: A national perspective.International journal of cardiology. Congenital heart disease · 2026Article
- A simplified prediction model for in-hospital mortality in children with congenital heart disease after surgery.Translational pediatrics · 2026Article
- Intersection of paediatric heart disease and foster care status: a multicentre retrospective cohort study.BMJ paediatrics open · 2026Observational
- Prediction model of postoperative mortality for congenital heart disease: evidence from two large-scale cohorts.Scientific reports · 2026Article
- Preoperative Transthoracic Echocardiogram Comprehensiveness and Diagnostic Errors in Patients Undergoing Congenital Heart Surgery.Pediatric cardiology · 2026Article
- Center Volume Not Associated with Survival Benefit of Inter-Hospital Transfer for Pediatric Cardiac Surgery.Pediatric cardiology · 2026Article
- Neurodevelopment Among Publicly Insured Children in the First 5 Years After Infant Heart Surgery.JAMA network open · 2026Article
- Risk factors for electrographic seizures in infants after cardiac surgery and their association with outcomes: a retrospective cohort study.Scientific reports · 2026Article
- Autism screening and diagnosis in children with congenital heart disease.Frontiers in pediatrics · 2026Article
- Predicting Reintubation in Postoperative Pediatric Cardiac Surgery: A Machine Learning Approach.Annals of cardiac anaesthesia · 2026Article
- Center Volume and Failure to Rescue in Pediatric Cardiac Surgery: Is There a Relationship?The Annals of thoracic surgery · 2026Article
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27 authors.
Funding
Abstract
backgroundAs the cardiac community strives to improve outcomes, accurate methods of risk stratification are imperative. Since adoption of International Classification of Disease-10th Revision (ICD-10) in 2015, there is no published method for congenital heart surgery risk stratification for administrative data.
objectivesThis study sought to develop an empirically derived, publicly available Risk Stratification for Congenital Heart Surgery (RACHS-2) tool for ICD-10 administrative data.
methodsThe RACHS-2 stratification system was iteratively and empirically refined in a training dataset of Pediatric Health Information Systems claims to optimize sensitivity and specificity compared with corresponding locally held Society of Thoracic Surgeons-Congenital Heart Surgery (STS-CHS) clinical registry data. The tool was validated in a second administrative data source: New York State Medicaid claims. Logistic regression was used to compare the ability of RACHS-2 in administrative data to predict operative mortality vs STAT Mortality Categories in registry data.
resultsThe RACHS-2 system captured 99.6% of total congenital heart surgery registry cases, with 1.0% false positives. RACHS-2 predicted operative mortality in both training and validation administrative datasets similarly to STAT Mortality Categories in registry data. C-statistics for models for operative mortality in training and validation administrative datasets-adjusted for RACHS-2-were 0.76 and 0.84 (95% CI: 0.72-0.80 and 0.80-0.89); C-statistics for models for operative mortality-adjusted for STAT Mortality Categories-in corresponding clinical registry data were 0.75 and 0.84 (95% CI: 0.71-0.79 and 0.79-0.89).
conclusionsRACHS-2 is a risk stratification system for pediatric cardiac surgery for ICD-10 administrative data, validated in 2 administrative-registry-linked datasets. Statistical code is publicly available upon request.
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