HEART REGIONAL REVIEW BOARD RESULTS/

STATUS JUSTIFICATION STATUS

Region 6

Status Justifications Submitted: January 1, 2016 - December 31, 2016

Table of Contents

Table 1. National Thoracic Status Justification Results: 1/1/2016-12/31/2016

Table 2. Region 6 Thoracic Status Justification Results: 1/1/2016-12/31/2016

Table 3. National Thoracic Status 1A Status Justification Results by Region: 1/1/2016-12/31/2016

Table 4. Thoracic Status 1A Criteria on Status Justifications: 1/1/2016-12/31/2016

Table 5. Thoracic Status 1A Adult Status Justification Criteria by Region:

1/1/2016-12/31/2016

Table 6. Thoracic Status 1A Pediatric Status Justification Criteria by Region:

1/1/2016-12/31/2016

Heart Regional Review Board Results: Region 6Spring 2017

Table 1. National Thoracic Status Justification Results: 1/1/2016-12/31/2016
Status justification outcome
Appropriate / Inappropriate / Indeterminate
N / % / N / % / N / %
Age Group / Listing Type / 5115 / 97.7 / 66 / 1.3 / 55 / 1.1
Adult / 1A - Listing
1A - Extension / 7098 / 99.4 / 26 / 0.4 / 20 / 0.3
1B - Special / 263 / 89.8 / 16 / 5.5 / 14 / 4.8
All / 12476 / 98.4 / 108 / 0.9 / 89 / 0.7
Pediatric / Listing Type / 204 / 99.5 / 1 / 0.5 / . / .
1A - Listing
1A - Extension / 517 / 99.8 / 1 / 0.2 / . / .
1B - Special / 78 / 90.7 / 3 / 3.5 / 5 / 5.8
All / 799 / 98.8 / 5 / 0.6 / 5 / 0.6
U.S. Total / 13275 / 98.5 / 113 / 0.8 / 94 / 0.7
Table 2. Region 6 Thoracic Status Justification Results: 1/1/2016-12/31/2016
Status justification outcome
Appropriate / Inappropriate / Indeterminate
N / % / N / % / N / %
Age Group / Listing Type / 160 / 97.6 / 4 / 2.4 / . / .
Adult / 1A - Listing
1A - Extension / 99 / 100.0 / . / . / . / .
1B – Special / 14 / 93.3 / . / . / 1 / 6.7
All / 273 / 98.2 / 4 / 1.4 / 1 / 0.4
Pediatric / Listing Type / 5 / 100.0 / . / . / . / .
1A - Listing
1A - Extension / 12 / 100.0 / . / . / . / .
1B – Special / 8 / 100.0 / . / . / . / .
All / 25 / 100.0 / . / . / . / .
Region 6 Total / 298 / 98.3 / 4 / 1.3 / 1 / 0.3
Table 3. National Thoracic Status 1A Status Justification Results by Region: 1/1/2016-12/31/2016
Region / # Patients with status justifications / # status justifications / Average # status justifications/ patient / Regional status justifications as % of National status justifications / Status justification outcome
Appropriate / Inappropriate / Indeterminate
N / % / N / % / N / %
1 / 209 / 921 / 4.4 / 7.0% / 911 / 98.9 / 1 / 0.1 / 9 / 1.0
2 / 356 / 1101 / 3.1 / 8.4% / 1094 / 99.4 / 7 / 0.6 / . / .
3 / 410 / 1589 / 3.9 / 12.1% / 1569 / 98.7 / 12 / 0.8 / 8 / 0.5
4 / 386 / 1311 / 3.4 / 10.0% / 1295 / 98.8 / 5 / 0.4 / 11 / 0.8
5 / 487 / 1545 / 3.2 / 11.8% / 1520 / 98.4 / 11 / 0.7 / 14 / 0.9
6 / 106 / 280 / 2.6 / 2.1% / 276 / 98.6 / 4 / 1.4 / . / .
7 / 374 / 1478 / 4.0 / 11.3% / 1462 / 98.9 / 10 / 0.7 / 6 / 0.4
8 / 157 / 518 / 3.3 / 4.0% / 516 / 99.6 / . / . / 2 / 0.4
9 / 300 / 1691 / 5.6 / 12.9% / 1665 / 98.5 / 13 / 0.8 / 13 / 0.8
10 / 301 / 943 / 3.1 / 7.2% / 931 / 98.7 / 4 / 0.4 / 8 / 0.8
11 / 432 / 1726 / 4.0 / 13.2% / 1695 / 98.2 / 27 / 1.6 / 4 / 0.2
U.S. Total / 3518 / 13103 / 3.7 / 100% / 12934 / 98.7 / 94 / 0.7 / 75 / 0.6

Data based on closed cases and subject to change based on future data submission or correction.

Heart Regional Review Board Results: Region 6Spring 2017

Table 4. Thoracic Status 1A Criteria on Status Justifications: 1/1/2016-12/31/2016
Age Group / Listing Type / Criteria / National / Region 6
N / % / N / %
Adult / Listing / A / 1991 / 16.1 / 67 / 25.5
B / 1272 / 10.3 / 52 / 19.8
C / 117 / 0.9 / 1 / 0.4
D / 1481 / 12.0 / 22 / 8.4
E / 375 / 3.0 / 22 / 8.4
Total status justifications / 5236 / 42.3 / 164 / 62.4
Extension / A / 505 / 4.1 / 5 / 1.9
B / 4067 / 32.9 / 79 / 30.0
C / 5 / 0.0 / . / .
D / 2079 / 16.8 / 5 / 1.9
E / 488 / 3.9 / 10 / 3.8
Total status justifications / 7144 / 57.7 / 99 / 37.6
Pediatric / Listing / A / 23 / 3.2 / 1 / 5.9
B / 47 / 6.5 / . / .
C / . / . / . / .
D / 15 / 2.1 / . / .
E / 109 / 15.1 / 4 / 23.5
F / 11 / 1.5 / . / .
Total status justifications / 205 / 28.4 / 5 / 29.4
Extension / A / 18 / 2.5 / 3 / 17.6
B / 138 / 19.1 / . / .
C / . / . / . / .
D / 11 / 1.5 / . / .
E / 279 / 38.6 / 9 / 52.9
F / 72 / 10.0 / . / .
Total status justifications / 518 / 71.6 / 12 / 70.6

Data based on closed cases and subject to change based on future data submission or correction.

Heart Regional Review Board Results: Region 6Spring 2017

Table 5. Thoracic Status 1A Adult Status Justification Criteria by Region:
1/1/2016-12/31/2016
Region / # Patients with status justifications / # Status justif. / Adult criteria
A / B / C / D / Exception
N / %1 / %2 / N / %1 / %2 / N / %1 / %2 / N / %1 / %2 / N / %1 / %2
1 / 204 / 908 / 137 / 5.5 / 15.1 / 584 / 10.9 / 64.3 / 2 / 1.6 / 0.2 / 174 / 4.9 / 19.2 / 11 / 1.3 / 1.2
2 / 334 / 1022 / 238 / 9.5 / 23.3 / 407 / 7.6 / 39.8 / 22 / 18.0 / 2.2 / 269 / 7.6 / 26.3 / 86 / 10.0 / 8.4
3 / 373 / 1466 / 219 / 8.8 / 14.9 / 570 / 10.7 / 38.9 / 8 / 6.6 / 0.5 / 488 / 13.7 / 33.3 / 181 / 21.0 / 12.3
4 / 361 / 1232 / 354 / 14.2 / 28.7 / 359 / 6.7 / 29.1 / 15 / 12.3 / 1.2 / 470 / 13.2 / 38.1 / 34 / 3.9 / 2.8
5 / 455 / 1455 / 293 / 11.7 / 20.1 / 209 / 3.9 / 14.4 / 4 / 3.3 / 0.3 / 812 / 22.8 / 55.8 / 137 / 15.9 / 9.4
6 / 99 / 263 / 72 / 2.9 / 27.4 / 131 / 2.5 / 49.8 / 1 / 0.8 / 0.4 / 27 / 0.8 / 10.3 / 32 / 3.7 / 12.2
7 / 349 / 1393 / 271 / 10.9 / 19.5 / 765 / 14.3 / 54.9 / 12 / 9.8 / 0.9 / 243 / 6.8 / 17.4 / 102 / 11.8 / 7.3
8 / 130 / 432 / 157 / 6.3 / 36.3 / 175 / 3.3 / 40.5 / 1 / 0.8 / 0.2 / 50 / 1.4 / 11.6 / 49 / 5.7 / 11.3
9 / 289 / 1663 / 246 / 9.9 / 14.8 / 820 / 15.4 / 49.3 / 32 / 26.2 / 1.9 / 462 / 13.0 / 27.8 / 103 / 11.9 / 6.2
10 / 285 / 900 / 187 / 7.5 / 20.8 / 391 / 7.3 / 43.4 / 4 / 3.3 / 0.4 / 248 / 7.0 / 27.6 / 70 / 8.1 / 7.8
11 / 407 / 1646 / 322 / 12.9 / 19.6 / 928 / 17.4 / 56.4 / 21 / 17.2 / 1.3 / 317 / 8.9 / 19.3 / 58 / 6.7 / 3.5
US Total / 3286 / 12380 / 2496 / 100.0 / 20.2 / 5339 / 100.0 / 43.1 / 122 / 100.0 / 1.0 / 3560 / 100.0 / 28.8 / 863 / 100.0 / 7.0
ADULT CRITERIA LEGEND
A = Mechanical circulatory support (i.e., VAD for 30 days, TAH, balloon pump, ECMO)
B = Mechanical circulatory support with device complications (i.e., thromboembolism, device infection/malfunction, ventricular arrhythmias)
C = Mechanical ventilation
D = Continuous infusion of single high dose or multiple inotropes and continuous monitoring of left ventricular pressures
Exception = Does not meet criteria (A)-(D) but who is considered to have an urgency and potential for benefit comparable to that of other patients in status 1A
%1 = % of status justifications for criterion occurring in each region (e.g., x% of all status justifications for criterion A occurred in region Y)
%2 = % of total regional status justifications involving each criterion (e.g., x% of all status justifications in region Y involved criterion A)
Table 6. Thoracic Status 1A Pediatric Status Justification Criteria by Region:
1/1/2016-12/31/2016
Region / # Patients with status justif. / # Status justif. / Pediatric criteria
A / B / C / D / E / Exception
N / %1 / %2 / N / %1 / %2 / N / %1 / %2 / N / %1 / %2 / N / %1 / %2 / N / %1 / %2
1 / 5 / 13 / 0 / 0.0 / 0.0 / 6 / 3.2 / 46.2 / 0 / . / 0.0 / 0 / 0.0 / 0.0 / 7 / 1.8 / 53.8 / 0 / 0.0 / 0.0
2 / 22 / 79 / 0 / 0.0 / 0.0 / 26 / 14.1 / 32.9 / 0 / . / 0.0 / 0 / 0.0 / 0.0 / 24 / 6.2 / 30.4 / 29 / 34.9 / 36.7
3 / 37 / 123 / 3 / 7.3 / 2.4 / 28 / 15.1 / 22.8 / 0 / . / 0.0 / 6 / 23.1 / 4.9 / 65 / 16.8 / 52.8 / 21 / 25.3 / 17.1
4 / 25 / 79 / 9 / 22.0 / 11.4 / 14 / 7.6 / 17.7 / 0 / . / 0.0 / 10 / 38.5 / 12.7 / 37 / 9.5 / 46.8 / 9 / 10.8 / 11.4
5 / 32 / 90 / 7 / 17.1 / 7.8 / 24 / 13.0 / 26.7 / 0 / . / 0.0 / 5 / 19.2 / 5.6 / 52 / 13.4 / 57.8 / 2 / 2.4 / 2.2
6 / 7 / 17 / 4 / 9.8 / 23.5 / 0 / 0.0 / 0.0 / 0 / . / 0.0 / 0 / 0.0 / 0.0 / 13 / 3.4 / 76.5 / 0 / 0.0 / 0.0
7 / 25 / 85 / 3 / 7.3 / 3.5 / 26 / 14.1 / 30.6 / 0 / . / 0.0 / 0 / 0.0 / 0.0 / 47 / 12.1 / 55.3 / 9 / 10.8 / 10.6
8 / 28 / 86 / 4 / 9.8 / 4.7 / 28 / 15.1 / 32.6 / 0 / . / 0.0 / 3 / 11.5 / 3.5 / 50 / 12.9 / 58.1 / 1 / 1.2 / 1.2
9 / 11 / 28 / 2 / 4.9 / 7.1 / 8 / 4.3 / 28.6 / 0 / . / 0.0 / 1 / 3.8 / 3.6 / 17 / 4.4 / 60.7 / 0 / 0.0 / 0.0
10 / 16 / 43 / 6 / 14.6 / 14.0 / 3 / 1.6 / 7.0 / 0 / . / 0.0 / 0 / 0.0 / 0.0 / 34 / 8.8 / 79.1 / 0 / 0.0 / 0.0
11 / 25 / 80 / 3 / 7.3 / 3.8 / 22 / 11.9 / 27.5 / 0 / . / 0.0 / 1 / 3.8 / 1.3 / 42 / 10.8 / 52.5 / 12 / 14.5 / 15.0
US Total / 233 / 723 / 41 / 100 / 5.7 / 185 / 100 / 25.6 / 0 / . / 0.0 / 26 / 100 / 3.6 / 388 / 100 / 53.7 / 83 / 100 / 11.5
PEDIATRIC CRITERIA LEGEND
A = Requires assistance with a ventilator
B = Mechanical assist device including ECMO
C = Balloon pump
D = <6 months old with congenital/acquired heart disease exhibiting pulmonary hypertension >50% of systemic level
E = Infusion of single high dose or multiple inotropes
Exception = Life expectancy <14 days without transplant
%1 = % of status justifications for criterion occurring in each region (e.g., x% of all status justifications for criterion A occurred in region Y)
%2 = % of total regionalstatus justifications involving each criterion (e.g., x% of all status justificationsin region Y involved criterion A)

Data based on closed cases and subject to change based on future data submission or correction.