What are the important morbidities associated with paediatric cardiac surgery? A mixed methods study

ObjectivesGiven the current excellent early mortality rates for paediatric cardiac surgery, stakeholders believe that this important safety outcome should be supplemented by a wider range of measures. Our objectives were to prospectively measure the incidence of morbidities following paediatric card...

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Bibliographic Details
Published in:BMJ open 2019-09, Vol.9 (9), p.e028533-e028533
Main Authors: Brown, Katherine L, Pagel, Christina, Ridout, Deborah, Wray, Jo, Anderson, David, Barron, David J, Cassidy, Jane, Davis, Peter, Hudson, Emma, Jones, Alison, Mclean, Andrew, Morris, Stephen, Rodrigues, Warren, Sheehan, Karen, Stoica, Serban, Tibby, Shane M, Witter, Thomas, Tsang, Victor T
Format: Article
Language:English
Subjects:
Adolescent
Age
Age Factors
Audits
Cardiac Surgical Procedures - adverse effects
Cardiac Surgical Procedures - mortality
Cardiovascular disease
Child
Child, Preschool
Congenital diseases
Epidemiology
Families & family life
Female
Focus groups
Heart Diseases - diagnosis
Heart Diseases - mortality
Heart Diseases - surgery
Heart surgery
Humans
Incidence
Infant
Infant, Newborn
Logistic Models
Male
Medical Audit
Medical malpractice
Mixed methods research
Morbidity
Mortality
Multimorbidity
Patients
Pediatrics
Postoperative Complications - diagnosis
Postoperative Complications - epidemiology
Prospective Studies
Quality Indicators, Health Care
Quality of life
Retreatment
Risk Assessment
Risk Factors
Surgery
Time Factors
Treatment Outcome
United Kingdom - epidemiology
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Summary:ObjectivesGiven the current excellent early mortality rates for paediatric cardiac surgery, stakeholders believe that this important safety outcome should be supplemented by a wider range of measures. Our objectives were to prospectively measure the incidence of morbidities following paediatric cardiac surgery and to evaluate their clinical and health-economic impact over 6 months.DesignThe design was a prospective, multicentre, multidisciplinary mixed methods study.SettingThe setting was 5 of the 10 paediatric cardiac surgery centres in the UK with 21 months recruitment.ParticipantsIncluded were 3090 paediatric cardiac surgeries, of which 666 patients were recruited to an impact substudy.ResultsFamilies and clinicians prioritised:Acute neurological event, unplanned re-intervention, feeding problems, renal replacement therapy, major adverse events, extracorporeal life support, necrotising enterocolitis, postsurgical infection and prolonged pleural effusion or chylothorax.Among 3090 consecutive surgeries, there were 675 (21.8%) with at least one of these morbidities. Independent risk factors for morbidity included neonatal age, complex heart disease and prolonged cardiopulmonary bypass (p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-028533