Original Article

Perfusion Measures and Outcomes (PERForm) registry: First annual report

¹ Medical University of South Carolina College of Health Professions, 151-A Rutledge Avenue, A321, Charleston, SC 29425, USA
² Department of Cardiac Surgery, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr., 5144 Cardiovascular Center, Ann Arbor, MI 48109-5864, USA
³ Division of Cardiovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
⁴ Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Arbor Lakes Building 3 #3130/4251 Plymouth Road, Ann Arbor, MI 48105, USA
⁵ Department of Perfusion Services, University of Tennessee Medical Center, 1924 Alcoa Hwy, Knoxville, TN 37920, USA
⁶ Division of Cardiothoracic Surgery, Emory University School of Medicine, 550 Peachtree Street, NE Davis-Fischer Bldg, 4th Floor, Atlanta, GA 30308, USA
⁷ Department of Cardiothoracic Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, 525 E 68th St M 404, New York, NY 10065, USA
⁸ Department of Cardiac Surgery, University of Michigan Health West, 2122 Health Dr. SW, Suite 133, Wyoming, MI 49519, USA
⁹ Cardiovascular Services, Detroit Medical Center Sinai Grace Hospital, 6001 West Outer Drive Suite POB 321, Detroit, MI 48235, USA
¹⁰ Cardiovascular Services, Ascension St. John Providence Health System, 16001 West Nine Mile Road, Southfield, MI 48075, USA

^* Corresponding author: likosky@med.umich.edu

Received: 2 February 2024
Accepted: 14 March 2024

Abstract

Background: The Perfusion Measures and Outcomes (PERForm) registry was established in 2010 to advance cardiopulmonary bypass (CPB) practices and outcomes. The registry is maintained through the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative and is the official registry of the American Society of Extracorporeal Technology. Methods: This first annual PERForm registry report summarizes patient characteristics as well as CPB-related practice patterns in adult (≥18 years of age) patients between 2019 and 2022 from 42 participating hospitals. Data from PERForm are probabilistically matched to institutional surgical registry data. Trends in myocardial protection, glucose, anticoagulation, temperature, anemia (hematocrit), and fluid management are summarized. Additionally, trends in equipment (hardware/disposables) utilization and employed patient safety practices are reported. Results: A total of 40,777 adult patients undergoing CPB were matched to institutional surgical registry data from 42 hospitals. Among these patients, 54.9% underwent a CABG procedure, 71.6% were male, and the median (IQR) age was 66.0 [58.0, 73.0] years. Overall, 33.1% of the CPB procedures utilized a roller pump for the arterial pump device, and a perfusion checklist was employed 99.6% of the time. The use of conventional ultrafiltration decreased over the study period (2019 vs. 2022; 27.1% vs. 24.9%) while the median (IQR) last hematocrit on CPB has remained stable [27.0 (24.0, 30.0) vs. 27.0 (24.0, 30.0)]. Pump sucker termination before protamine administration increased over the study period: (54.8% vs. 75.9%). Conclusion: Few robust clinical registries exist to collect data regarding the practice of CPB. Although data submitted to the PERForm registry demonstrate overall compliance with published perfusion evidence-based guidelines, noted opportunities to advance patient safety and outcomes remain.