Literature DB >> 11465173

Assessment of mortality rates for congenital heart defects and surgeons' performance.

J F Stark1, S Gallivan, K Davis, J R Hamilton, J L Monro, J C Pollock, K G Watterson.   

Abstract

BACKGROUND: In the absence of reliable national data, we have collected results of all operations for congenital heart defects from five departments to assess mortality rates and compare them among surgeons and departments.
METHODS: Data relating to all operations (2,718) carried out at the five centers during a period from April 1, 1997 through March 31, 1999. Clearly defined criteria were agreed for the classification of patients into various subgroups.
RESULTS: The overall hospital mortality was 4.4% (95% confidence intervals 3.7%-5.3%). Mortality for open-operations was 12.6% in neonates, 5.1% in infants, and 3.5% in children. Mortality rates were 1.1% for coarctation, 0.4% ventricular septal defect, 4.1% atrioventricular septal defect, 2.9% Fallot, 0.9% switch, and 15.6% truncus arteriosus. Although individual surgeons' mortality rates ranged from 1.8% to 7.5%, none of the 12 surgeons' data were above 95% confidence intervals. For individual surgeons, the change in mortality rates between the 2 years ranged between -3.3% and +3.8%.
CONCLUSIONS: With 2 years' data available, estimates of mortality rates are more precise as reflected by tighter confidence intervals. There were relatively small data sets for individual hospitals and surgeons, which made statistical evaluation difficult. For setting standards, data from more departments for a longer period will be required. Statistical methods alone cannot be used as a sole arbiter of what is considered acceptable performance.

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Year:  2001        PMID: 11465173     DOI: 10.1016/s0003-4975(01)02689-3

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


  11 in total

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2.  EM for regularized zero-inflated regression models with applications to postoperative morbidity after cardiac surgery in children.

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Journal:  Pediatr Cardiol       Date:  2014-06-04       Impact factor: 1.655

4.  Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

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Journal:  Ann Thorac Surg       Date:  2011-12       Impact factor: 4.330

5.  Blood lactate levels differ significantly between surviving and nonsurviving patients within the same risk-adjusted Classification for Congenital Heart Surgery (RACHS-1) group after pediatric cardiac surgery.

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Review 6.  Patient safety and human factors in pediatric cardiac surgery.

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7.  Surgical volume and center effects on early mortality after pediatric cardiac surgery: 25-year North American experience from a multi-institutional registry.

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8.  Junctional ectopic tachycardia after surgery for congenital heart disease in children.

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9.  The importance of nomenclature for congenital cardiac disease: implications for research and evaluation.

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10.  Myocardial performance index after surgical correction of ventricular septal defects.

Authors:  Yasser Baghdady; Yasser Kamel; Waleed Amar
Journal:  Arch Med Sci       Date:  2010-06-30       Impact factor: 3.318

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