Document Detail


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.
MedLine Citation:
PMID:  14982866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
John L Gibbs; James L Monro; David Cunningham; Anthony Rickards; ; ;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-02-24
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  328     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-12     Completed Date:  2004-03-26     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  611     Citation Subset:  AIM; IM    
Affiliation:
Central Cardiac Audit Database, Department of Paediatric Cardiology, Leeds General Infirmary, Calverley, Leeds LS1 3EX. jgibbs@boltblue.com
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MeSH Terms
Descriptor/Qualifier:
Cardiac Catheterization
Child
Child, Preschool
Cohort Studies
Confidentiality
Coronary Artery Bypass / mortality
Data Collection
Heart Defects, Congenital / mortality*,  therapy*
Humans
Infant
Infant, Newborn
Medical Audit
Prognosis
Risk Assessment
Survival Analysis
Comments/Corrections
Comment In:
BMJ. 2004 Mar 13;328(7440):594-5   [PMID:  15016663 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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