Literature DB >> 14982866

Survival after surgery or therapeutic catheterisation for congenital heart disease in children in the United Kingdom: analysis of the central cardiac audit database for 2000-1.

John L Gibbs1, James L Monro, David Cunningham, Anthony Rickards.   

Abstract

OBJECTIVES: To analyse simple national statistics and survival data collected in the central cardiac audit database after treatment for congenital heart disease and to provide long term comparative statistics for each contributing centre.
DESIGN: Prospective, longitudinal, observational, national cohort survival study.
SETTING: UK central cardiac audit database. MAIN OUTCOME MEASURES: Survival at 30 days and one year after treatment in the year April 2000-March 2001, assessed by using both volunteered life status and independently validated life status through the Office for National Statistics, using the patient's unique NHS number, or the general register offices of Scotland and Northern Ireland. Institutional results following a group of six benchmark operations and three benchmark catheterisation procedures.
RESULTS: Since April 2000 data have been received from all 13 UK tertiary centres performing cardiac surgery or therapeutic cardiac catheterisation in children with congenital heart disease. Altogether 3666 surgical procedures and 1828 therapeutic catheterisations were performed. Central tracking of mortality identified 469 deaths, 194 occurring within 30 days and 275 later. Forty two of the 194 deaths within 30 days were detected by central tracking but not by volunteered data. For surgery overall, survival at 30 days was 94.9%, falling to 91.2% at one year; this effect was most marked for infants. For therapeutic catheterisation survival at 30 days was 99.1%, falling to 98.1% at one year. Survival of individual centres or individual operators did not differ from the national average after benchmark procedures.
CONCLUSIONS: Independent data validation is essential for accurate survival analysis. One year survival gives a more realistic view of outcome than traditional perioperative mortality. Currently no detectable difference exists in survival between any of the 13 UK tertiary congenital heart disease centres, but confidence intervals for small centres are wide, limiting our power to detect underperformance from analysis of a single year's data. Appropriately resourced, focused national audit is capable of accurate data collection on which nationwide, long term quality control can be based.

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Year:  2004        PMID: 14982866      PMCID: PMC381132          DOI: 10.1136/bmj.38027.613403.F6

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  9 in total

1.  Report of the Coding Committee of the Association for European Paediatric Cardiology.

Authors:  R C Franklin; R H Anderson; O Daniëls; M Elliott; M H Gewillig; R Ghisla; O N Krogmann; H E Ulmer; F P Stocker
Journal:  Cardiol Young       Date:  2000       Impact factor: 1.093

2.  Congenital Heart Surgery Nomenclature and Database Project: overview and minimum dataset.

Authors:  C Mavroudis; J P Jacobs
Journal:  Ann Thorac Surg       Date:  2000-04       Impact factor: 4.330

3.  Early identification of divergent performance in congenital cardiac surgery.

Authors:  S Gallivan; K B Davis; J F Stark
Journal:  Eur J Cardiothorac Surg       Date:  2001-12       Impact factor: 4.191

4.  Comparison of UK paediatric cardiac surgical performance by analysis of routinely collected data 1984-96: was Bristol an outlier?

Authors:  P Aylin; B Alves; N Best; A Cook; P Elliott; S J Evans; A E Lawrence; G D Murray; J Pollock; D Spiegelhalter
Journal:  Lancet       Date:  2001-07-21       Impact factor: 79.321

5.  Two-sided confidence intervals for the single proportion: comparison of seven methods.

Authors:  R G Newcombe
Journal:  Stat Med       Date:  1998-04-30       Impact factor: 2.373

6.  Late results of pediatric cardiac surgery in Finland: a population-based study with 96% follow-up.

Authors:  H P Nieminen; E V Jokinen; H I Sairanen
Journal:  Circulation       Date:  2001-07-31       Impact factor: 29.690

Review 7.  Consensus-based method for risk adjustment for surgery for congenital heart disease.

Authors:  Kathy J Jenkins; Kimberlee Gauvreau; Jane W Newburger; Thomas L Spray; James H Moller; Lisa I Iezzoni
Journal:  J Thorac Cardiovasc Surg       Date:  2002-01       Impact factor: 5.209

8.  Presentation of the International Nomenclature for Congenital Heart Surgery. The long way from nomenclature to collection of validated data at the EACTS.

Authors:  F Lacour-Gayet; B Maruszewski; C Mavroudis; J P Jacobs; M J Elliott
Journal:  Eur J Cardiothorac Surg       Date:  2000-08       Impact factor: 4.191

9.  Mortality rates after surgery for congenital heart defects in children and surgeons' performance.

Authors:  J Stark; S Gallivan; J Lovegrove; J R Hamilton; J L Monro; J C Pollock; K G Watterson
Journal:  Lancet       Date:  2000-03-18       Impact factor: 79.321

  9 in total
  17 in total

1.  Pre-hospital resuscitation: breathing life into a stale subject.

Authors:  C F M Weston
Journal:  Heart       Date:  2004-10       Impact factor: 5.994

2.  Congenital heart disease.

Authors:  Tom Treasure
Journal:  BMJ       Date:  2004-03-13

3.  Paediatric cardiac surgical mortality after Bristol: paediatric cardiac hospital episode statistics are unreliable.

Authors:  John L Gibbs; David Cunningham; Marc de Leval; James Monro; Bruce Keogh
Journal:  BMJ       Date:  2005-01-01

4.  Cardiac mortality in children in Oxford hospital is not excessive.

Authors:  Caroline White
Journal:  BMJ       Date:  2005-02-12

5.  Surgery for congenital heart conditions in Oxford.

Authors:  Bruce Keogh
Journal:  BMJ       Date:  2005-02-12

Review 6.  Tetralogy of Fallot: from fetus to adult.

Authors:  Elliot A Shinebourne; Sonya V Babu-Narayan; Julene S Carvalho
Journal:  Heart       Date:  2006-09       Impact factor: 5.994

7.  Survival and Associated Risk Factors for Mortality Among Infants with Critical Congenital Heart Disease in a Developing Country.

Authors:  Mohd Nizam Mat Bah; Mohd Hanafi Sapian; Mohammad Tamim Jamil; Amelia Alias; Norazah Zahari
Journal:  Pediatr Cardiol       Date:  2018-05-14       Impact factor: 1.655

Review 8.  Patient safety and human factors in pediatric cardiac surgery.

Authors:  Emile A Bacha
Journal:  Pediatr Cardiol       Date:  2007-01-25       Impact factor: 1.655

Review 9.  Nomenclature and databases - the past, the present, and the future : a primer for the congenital heart surgeon.

Authors:  Jeffrey Phillip Jacobs; Constantine Mavroudis; Marshall Lewis Jacobs; Bohdan Maruszewski; Christo I Tchervenkov; Francois G Lacour-Gayet; David Robinson Clarke; J William Gaynor; Thomas L Spray; Hiromi Kurosawa; Giovanni Stellin; Tjark Ebels; Emile A Bacha; Henry L Walters; Martin J Elliott
Journal:  Pediatr Cardiol       Date:  2007-05-04       Impact factor: 1.655

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

Authors:  Jeffrey M Vinocur; Jeremiah S Menk; John Connett; James H Moller; Lazaros K Kochilas
Journal:  Pediatr Cardiol       Date:  2013-02-02       Impact factor: 1.655

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