Katherine L Brown1, Christina Pagel2, Rhian Brimmell3, Kate Bull1, Peter Davis4, Rodney C Franklin5, Aparna Hoskote1, Natasha Khan6, Warren Rodrigues7, Sara Thorne8, Liz Smith1, Linda Chigaru1, Martin Utley2, Jo Wray1, Victor Tsang1, Andrew Mclean7. 1. 1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom. 2. 2Clinical Operational Research Unit,University College London,London,United Kingdom. 3. 3Department Paediatric Cardiology and Cardiac Surgery,Evelina London Children's Hospital,London,United Kingdom. 4. 4Paediatric Intensive Care Unit,Bristol Royal Hospital for Children,Bristol,United Kingdom. 5. 5Paediatric Cardiology Department,Royal Brompton and Harefield NHS Foundation Trust,London,United Kingdom. 6. 6Department of Cardiac Surgery,Birmingham Children's Hospital,Birmingham,United Kingdom. 7. 7Departments of Paediatric Intensive Care and Paediatric Cardiac Surgery,Royal Hospital for Children at Yorkhill,Glasgow,United Kingdom. 8. 8Department of Cardiology,University Hospital Birmingham,Birmingham,United Kingdom.
Abstract
BACKGROUND: Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance. METHODS: As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients. RESULTS: We present a set of definitions of morbidity for use in routine audit after paediatric cardiac surgery. These morbidities are ranked in priority order as acute neurological event, unplanned re-operation, feeding problems, the need for renal support, major adverse cardiac events or never events, extracorporeal life support, necrotising enterocolitis, surgical site of blood stream infection, and prolonged pleural effusion or chylothorax. It is recognised that more than one such morbidity may arise in the same patient and these are referred to as multiple morbidities, except in the case of extracorporeal life support, which is a stand-alone constellation of morbidity. CONCLUSIONS: It is feasible to define a range of paediatric cardiac surgical morbidities for use in routine audit that reflects the priorities of both professionals and parents. The impact of these morbidities on the patient and family will be explored prospectively as part of a wider ongoing, multi-centre study.
BACKGROUND: Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance. METHODS: As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients. RESULTS: We present a set of definitions of morbidity for use in routine audit after paediatric cardiac surgery. These morbidities are ranked in priority order as acute neurological event, unplanned re-operation, feeding problems, the need for renal support, major adverse cardiac events or never events, extracorporeal life support, necrotising enterocolitis, surgical site of blood stream infection, and prolonged pleural effusion or chylothorax. It is recognised that more than one such morbidity may arise in the same patient and these are referred to as multiple morbidities, except in the case of extracorporeal life support, which is a stand-alone constellation of morbidity. CONCLUSIONS: It is feasible to define a range of paediatric cardiac surgical morbidities for use in routine audit that reflects the priorities of both professionals and parents. The impact of these morbidities on the patient and family will be explored prospectively as part of a wider ongoing, multi-centre study.
Entities:
Keywords:
Morbidity; complication; outcome; paediatric cardiac surgery
Authors: Luca Grieco; Christina Pagel; Martin Utley; David J Barron; Serban Stoica; Shane Tibby; Warren Rodrigues; Victor Tsang; Katherine L Brown Journal: Cardiol Young Date: 2019-12-17 Impact factor: 1.093
Authors: Christina Pagel; Catherine Bull; Martin Utley; Jo Wray; David J Barron; Serban Stoica; Shane M Tibby; Victor Tsang; Katherine L Brown Journal: BMJ Paediatr Open Date: 2019-03-22
Authors: Emma Hudson; Katherine Brown; Christina Pagel; Jo Wray; David Barron; Warren Rodrigues; Serban Stoica; Shane M Tibby; Victor Tsang; Deborah Ridout; Stephen Morris Journal: Arch Dis Child Date: 2020-05-07 Impact factor: 3.791
Authors: Katherine L Brown; Christina Pagel; Deborah Ridout; Jo Wray; David Anderson; David J Barron; Jane Cassidy; Peter Davis; Emma Hudson; Alison Jones; Andrew Mclean; Stephen Morris; Warren Rodrigues; Karen Sheehan; Serban Stoica; Shane M Tibby; Thomas Witter; Victor T Tsang Journal: BMJ Open Date: 2019-09-09 Impact factor: 2.692
Authors: Jo Wray; Deborah Ridout; Alison Jones; Peter Davis; Paul Wellman; Warren Rodrigues; Emma Hudson; Victor Tsang; Christina Pagel; Katherine L Brown Journal: Ann Thorac Surg Date: 2020-11-27 Impact factor: 4.330