Higher programmatic volume in paediatric heart surgery is associated with better early outcomes.
PBN-AR
Instytucja
Instytut "Pomnik - Centrum Zdrowia Dziecka"
Informacje podstawowe
Główny język publikacji
en
Czasopismo
CARDIOLOGY IN THE YOUNG
ISSN
1047-9511
EISSN
1467-1107
Wydawca
Cambridge University Press
Rok publikacji
2015
Numer zeszytu
8
Strony od-do
1572-1578
Numer tomu
25
Identyfikator DOI
Liczba arkuszy
Autorzy
(liczba autorów: 6)
Pozostali autorzy
+ 4
Słowa kluczowe
en
congenital heart disease
early results
outcome
paediatric heart disease
patient safety
Streszczenia
Język
en
Treść
OBJECTIVE: Previous analyses have suggested an association between centre volume and in-hospital mortality, post-operative complications, and mortality in those patients who suffer from a complication. We sought to determine the nature of this association using a multicentre cohort. METHODS: All the patients, aged 18 years or younger, undergoing heart surgery at centres participating in the European Congenital Heart Surgeons Database (2003-2013) were included. Programmes were grouped as follows: small 350. Multivariable logistic regression was used to identify the differences between groups with the adjusted in-hospital mortality, onset of any and/or major complication, and in-hospital mortality in those patients with any and/or major complication. The outcomes were adjusted for patient specific risk factors and surgical risk factors. RESULTS: The data set consisted of 119,345 procedures performed in 99 centres. Overall, in-hospital mortality was 4.63%; complications occurred in 23.4% of the patients. In-hospital mortality in patients with complications was 13.82%. Multivariable logistic regression showed that the risk of in-hospital death was higher in low- and medium-volume centres (p<0.001). The rate of the occurrence of any post-operative complication in small, medium, and large programmes was lower compared with very large centres (p<0.001). Low- and medium-volume centres were associated with significantly higher mortality in patients with any complication (p<0.001). CONCLUSIONS: Our analysis showed that the risk of in-hospital mortality was lower in higher-volume centres. Although the risk of complications is higher in high-volume centres, the mortality associated with complications that occurred in these centres was lower.
Cechy publikacji
original-article
Inne
System-identifier
0000014826
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