Quality assurance of paediatric cardiac surgery: A prospective 6-year analysis

Justo, RN, Janes, EF, Sargent, PH, Jalali, H and Pohlner, PG (2004) Quality assurance of paediatric cardiac surgery: A prospective 6-year analysis. Journal of Paediatrics And Child Health, 40 3: 144-148.


Author Justo, RN
Janes, EF
Sargent, PH
Jalali, H
Pohlner, PG
Title Quality assurance of paediatric cardiac surgery: A prospective 6-year analysis
Journal name Journal of Paediatrics And Child Health   Check publisher's open access policy
ISSN 1034-4810
Publication date 2004
Sub-type Article (original research)
DOI 10.1111/j.1440-1754.2004.00316.x
Volume 40
Issue 3
Start page 144
End page 148
Total pages 5
Editor F. Oberklaid
Place of publication Australia
Publisher Blackwell Publishing Asia
Collection year 2004
Language eng
Subject C1
321019 Paediatrics
321029 Surgery
730204 Child health
Abstract Objective: To audit effective quality assurance methods to monitor outcomes following paediatric cardiac surgery at a single institution. Methods: All patients undergoing cardiac surgery from January 1996 to December 2001 were enrolled prospectively. Patients were stratified by complexity of surgical procedure into four groups, with Category 4 being the most complex procedure. Outcome measures included death, length of admission and morbidity from complications. Results: A total of 1815 patients underwent 1973 surgical procedures. Of these, 1447 (73.3%) were cardiopulmonary bypass procedures, and 543 (27.5%) were more complex (Category 3 and 4) procedures. Median patient age was 3.5 years (range, 1 day-20 years) and patient weight 15.0 kg (range, 900 g to 90 kg). Sixty-six patients (3.6%) died during the study period. Of the procedures in 1996, 22.7% were classified as complex compared with 29.2% of procedures in 2001. The annual surgical mortality ranged from 1.9-4.7% (P=0.20), and when mortality was adjusted for complexity of surgery, there was no significant yearly variation in the mortality rate (P=0.57). Analysis of individual surgeon's results showed no significant difference in the mortality rate by complexity of surgery performed (P=0.90). Mean ventilation times did not change significantly over time (P=0.79). The yearly incidence of significant neurological complications ranged from 0.6% to 4.5% and the incidence of arrhythmias from 4.2% to 8.0%. No difference was detected between the years. Conclusions: Stratifying complexity of surgery proved valuable in monitoring surgical outcomes and detecting differences in performance over time as large subgroups were created for analysis.
Keyword Pediatrics
Paediatric Cardiac Surgery
Quality Assurance
Congenital Heart-defects
In-hospital Mortality
Performance
Operation
Outcomes
Volume
Repair
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2005 Higher Education Research Data Collection
Centre for Online Health Publications
 
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