An empirically based tool for analyzing mortality associated with congenital heart surgery

O’Brien, Sean M.; Clarke, David R.; Jacobs, Jeffrey P.; Jacobs, Marshall L.; Lacour-Gayet, François; Pizarro, Christian; Welke, Karl F.; Maruszewski, Bohdan; Tobota, Zdzisław; Miller, Weldon J.; Hamilton, Leslie; Peterson, Eric D.; Mavroudis, Constantine; Edwards, Fred H.

doi:10.1016/j.jtcvs.2009.03.071

Cited by 630 publications

(581 citation statements)

References 12 publications

(13 reference statements)

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“…Patient region was chosen as the variable of interest as it more accurately reflected location where prenatal care took place, rather than the geographical location where the surgical intervention was performed. Patient region was classified by both individual state as well as by the United States Department of Health and Human Services (USDHHS) ten geographic regions 21 . The USDHHS regional classification system assigns a number and a major city to each region.…”

Section: Patient Regionmentioning

confidence: 99%

Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

2015

PEDIATRICS

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Section: Patient Regionmentioning

confidence: 99%

Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

2015

PEDIATRICS

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“…[4][5][6][7] Se consideró complicación aquella condición que implicara tratamiento adicional y/o prolongación de internación y/o riesgo potencial de vida para el paciente.…”

Section: Pacientes Y Métodosunclassified

Cierre de comunicación interventricular en menores de un año en un hospital público

et al. 2014

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“…22 This system was recently developed based on empirical data from nearly 80 000 patients, and it includes a greater number of operations compared with other risk stratification systems. 22 Only the first cardiovascular operation of the admission was analyzed.…”

Section: Study Populationmentioning

confidence: 99%

“…23 The primary operation performed was classified by STS-EACTS risk category. 22 Center characteristics were also collected, including region of the country and average annual center surgical volume of STS-EACTS classified cases during the study period.…”

Section: Data Collectionmentioning

confidence: 99%

Association of Center Volume With Mortality and Complications in Pediatric Heart Surgery

2012

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WHAT'S KNOWN ON THIS SUBJECT: Previous analyses have suggested that center volume is associated with outcome in children undergoing heart surgery. There are limited data regarding factors that may mediate this volume-outcome relationship. WHAT THIS STUDY ADDS:A multicenter analysis of 35 776 children revealed that the higher mortality observed at lower volume centers may be related to a higher rate of mortality in those with postoperative complications, rather than a higher rate of complications alone. abstract OBJECTIVE: Previous analyses have suggested center volume is associated with outcome in children undergoing heart surgery. However, data are limited regarding potential mediating factors, including the relationship of center volume with postoperative complications and mortality in those who suffer a complication. We examined this association in a large multicenter cohort.METHODS: Children 0 to 18 years undergoing heart surgery at centers participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2006Database ( -2009 were included. In multivariable analysis, we evaluated outcomes associated with annual center volume, adjusting for patient factors and surgical risk category.RESULTS: A total of 35 776 patients (68 centers) were included. Overall, 40.6% of patients had $1 complication, and the in-hospital mortality rate was 3.9%. The mortality rate in those patients with a complication was 9.0%. In multivariable analysis, lower center volume was significantly associated with higher in-hospital mortality. There was no association of center volume with the rate of postoperative complications, but lower center volume was significantly associated with higher mortality in those with a complication (P = .03 when volume examined as a continuous variable; odds ratio in centers with ,150 vs .350 cases per year = 1.59 [95% confidence interval: 1.16-2.18]). This association was most prominent in the higher surgical risk categories.CONCLUSIONS: These data suggest that the higher mortality observed at lower volume centers in children undergoing heart surgery may be related to a higher rate of mortality in those with postoperative complications, rather than a higher rate of complications alone. Pediatrics 2012;129:e370-e376 AUTHORS:

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An empirically based tool for analyzing mortality associated with congenital heart surgery

Cited by 630 publications

References 12 publications

Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

Cierre de comunicación interventricular en menores de un año en un hospital público

Association of Center Volume With Mortality and Complications in Pediatric Heart Surgery

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