• Hanna A Jensen, Katherine L Brown, Christina Pagel, David J Barron, and Rodney C G Franklin.
• Cardiac Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.
• Br. Med. Bull. 2014 Sep 1; 111 (1): 5-15.

IntroductionMortality has traditionally been perceived as a straightforward measure of outcome and has been used to evaluate surgical performance. In the rapidly developing arena of paediatric cardiac surgery, the insightful analysis of mortality figures is challenging.Sources Of DataThis report discusses the issues involved when mortality is used as a marker for surgical outcome, referring to national and international audit and research data.Areas Of AgreementMortality is an important variable and should be transparently defined, reported and monitored.Areas Of ControversyDefinitions of mortality, assessments of risk and interpretations of reported statistics all have limitations that must be recognized.Growing PointsTraditional use of raw early mortality as a simplistic indicator of outcome and performance is evolving to include risk-adjusted mortality, longer-term survival, reinterventions and complications.Areas Timely For Developing ResearchAs the vast majority of children undergoing cardiac surgery now survive beyond 30 days, the focus for measures of quality is shifting towards morbidity.© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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