ArticleBMJ open2019
What are the important morbidities associated with paediatric cardiac surgery? A mixed methods study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Postoperative complications after paediatric cardiac surgery: the role of ethnicity and deprivation - a national cohort study.Archives of disease in childhood · 2026Article
- Risk Models for Monitoring Postoperative Complication Rates After Paediatric Cardiac Surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Evaluating Long-Term Outcomes of Children Undergoing Surgical Treatment for Congenital Heart Disease for National Audit in England and Wales.Journal of the American Heart Association · 2024Article
- Risk factors and early outcomes associated with prolonged pleural effusion/chylothorax after paediatric cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- The Impact of Morbidities Following Pediatric Cardiac Surgery on Family Functioning and Parent Quality of Life.Pediatric cardiology · 2024Article
- Hospital resource utilization in a national cohort of functionally single ventricle patients undergoing surgical treatment.JTCVS open · 2023Article
- Alternative Hybrid Approach to Promote Native Pulmonary Artery Growth in Pulmonary Atresia VSD MAPCAs.JACC. Case reports · 2022Article
- Prognostic Model to Predict Postoperative Adverse Events in Pediatric Patients With Aortic Coarctation.Frontiers in cardiovascular medicine · 2021Article
- Costs of postoperative morbidity following paediatric cardiac surgery: observational study.Archives of disease in childhood · 2020Observational
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
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<0.001). Among patients with morbidity, 6-month survival was 88.2% (95% CI 85.4 to 90.6) compared with 99.3% (95% CI 98.9 to 99.6) with none of the morbidities (p<0.001). The impact substudy in 340 children with morbidity and 326 control children with no morbidity indicated that morbidity-related impairment in quality of life improved between 6 weeks and 6 months. When compared with children with no morbidities, those with morbidity experienced a median of 13 (95% CI 10.2 to 15.8, p<0.001) fewer days at home by 6 months, and an adjusted incremental cost of £21 292 (95% CI £17 694 to £32 423, p<0.001).
conclusionsEvaluation of postoperative morbidity is more complicated than measuring early mortality. However, tracking morbidity after paediatric cardiac surgery over 6 months offers stakeholders important data that are of value to parents and will be useful in driving future quality improvement.
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