Cardiology in the young
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Cardiology in the young · Dec 2008
ReviewCongenital cardiac surgical complications of the integument, vascular system, vascular-line(s), and wounds: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.
A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. ⋯ A comprehensive list of complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.
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Cardiology in the young · Dec 2008
ReviewDatabases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease--the perspective of cardiology.
This review includes a brief discussion, from the perspective of the pediatric cardiologist, of the rationale for creation and maintenance of multi-institutional databases of outcomes of the treatment of patients with congenital and paediatric cardiac disease, together with a history of the evolution of such databases, and a description of the current state of the art. A number of projects designed to have broad-based impact are currently in the design phase, or have already been implemented. ⋯ These projects, each leveraging multicentre data and collaboration, demonstrate the enormous progress that has occurred over the last several years to improve the quality and consistency of information about nonsurgical treatment for congenital cardiac disease. The paediatric cardiology field is well-poised to move quickly beyond outcome assessment and benchmarking, to collaborative quality improvement.
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Cardiology in the young · Dec 2008
ReviewDatabases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease--a comparison of administrative and clinical data.
The introduction of the reporting of medical and surgical outcomes to the public and the potential implementation of initiatives involving pay-for-performance have invigorated debates about the relative benefits of administrative and clinical databases for comparing rates of mortality at the level of the hospital and surgeon. While general agreement exists that public performance report cards must use the highest quality data available, debate continues regarding whether administrative or clinical data should be utilized for this purpose. ⋯ Particularly problematic to congenital heart surgery is the non-uniform application of coding algorithms to define complex reconstructive procedures for which there is no unique code assignment. The purposes of this manuscript are; therefore, to discuss the relative advantages and limitations of both clinical and administrative data, and to provide a brief introduction to currently available databases germane to the study of congenital cardiac disease.
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Cardiology in the young · Dec 2008
ReviewRenal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.
A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. ⋯ This lack of knowledge is in part due to the lack of uniform definitions of these postoperative complications. The purpose of this effort is to propose consensus definitions for renal complications following congenital cardiac surgery so that collection of such data can be standardized. Clinicians caring for patients with congenital heart disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment.
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Cardiology in the young · Dec 2008
ReviewCardiac complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.
A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. ⋯ These cardiac complications are presented in the following subgroups: 1) Cardiac (general), 2) Cardiac--Metabolic, 3) Cardiac--Residual and Recurrent cardiac lesions, 4) Arrhythmia, 5) Cardiopulmonary bypass and mechanical circulatory support, and 6) Operative/Procedural. Within each subgroup, complications are presented in alphabetical order. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment.