ArticleJournal of the American College of Cardiology2019
Improvement in Pediatric Cardiac Surgical Outcomes Through Interhospital Collaboration.
Article in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of Subspecialty Pediatric Palliative Care on Children with Heart Disease; A Systematic Review and Meta-analysis.Pediatric cardiology · 2025Pooled it
- National Variation in Congenital Heart Surgery Outcomes.Circulation · 2020Trial
- Patient Characteristics Associated with 30-Day Readmission to a Pediatric Cardiac Center.Pediatric cardiology · 2026Article
- Geospatial Access to Pediatric Cardiac and Cardiac-Surgical Services by Neighborhood-Level Determinants of Health.Journal of the American Heart Association · 2026Article
- Hyperoxia During Neonatal Cardiopulmonary Bypass Is Associated With Worse Clinical Outcomes: A Multi-Institutional Study.Journal of the American Heart Association · 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
- Retrospective Analysis of a Multicenter Observational Study of the Relationship Between Social Determinants of Health and Complications After Children's Heart Surgery.Critical care explorations · 2025Observational
- Clinical practice and outcomes in European pediatric cardiac anesthesia: A secondary analysis of the APRICOT and NECTARINE studies.Acta anaesthesiologica Scandinavica · 2025Article
- Enhancing Quality of Congenital Heart Care Within Resource-Limited Settings.Pediatric cardiology · 2025Review
- Telemedicine in critical care: collaborative experience in postoperative pediatric cardiac care.Archivos de cardiologia de Mexico · 2025Article
- Geospatial disparities in pediatric heart failure care in China: a multicenter cohort study.Frontiers in public health · 2025Article
- Sustained Performance of Cardiac Arrest Prevention in Pediatric Cardiac Intensive Care Units.JAMA network open · 2024Observational
- Association Between Past and Present Operative Mortality in Congenital Heart Surgery: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.The Annals of thoracic surgery · 2024Article
- 2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic.Journal of arrhythmia · 2023Article
- 2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Fetal Brain Development in Congenital Heart Disease.The Canadian journal of cardiology · 2023Review
- Declining Incidence of Postoperative Neonatal Brain Injury in Congenital Heart Disease.Journal of the American College of Cardiology · 2023Article
- Effects of on-Table Extubation after Pediatric Cardiac Surgery.Journal of clinical medicine · 2022Article
- Cohort study of intervened functionally univentricular heart in England and Wales (2000-2018).Heart (British Cardiac Society) · 2022Article
- The horizon of pediatric cardiac critical care.Frontiers in pediatrics · 2022Review
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Authors and funding
19 authors.
Funding
Abstract
backgroundPatients undergoing complex pediatric cardiac surgery remain at considerable risk of mortality and morbidity, and variation in outcomes exists across hospitals. The Pediatric Cardiac Critical Care Consortium (PC4) was formed to improve the quality of care for these patients through transparent data sharing and collaborative learning between participants.
objectivesThe purpose of this study was to determine whether outcomes improved over time within PC4.
methodsThe study analyzed 19,600 hospitalizations (18 hospitals) in the PC4 clinical registry that included cardiovascular surgery from August 2014 to June 2018. The primary exposure was 2 years of PC4 participation; this provided adequate time for hospitals to accrue data and engage in collaborative learning. Aggregate case mix-adjusted outcomes were compared between the first 2 years of participation (baseline) and all months post-exposure. We also evaluated outcomes from the same era in a cohort of similar, non-PC4 hospitals.
resultsDuring the baseline period, there was no evidence of improvement. We observed significant improvement in the post-exposure period versus baseline for post-operative intensive care unit mortality (2.1% vs. 2.7%; 22% relative reduction [RR]; p = 0.001), in-hospital mortality (2.5% vs. 3.3%; 24% RR; p = 0.001), major complications (10.1% vs. 11.5%; 12% RR; p < 0.001), intensive care unit length of stay (7.3 days vs. 7.7 days; 5% RR; p < 0.001), and duration of ventilation (61.3 h vs. 70.6 h; 13% RR; p = 0.01). Non-PC4 hospitals showed no significant improvement in mortality, complications, or hospital length of stay.
conclusionsThis analysis demonstrates improving cardiac surgical outcomes at children's hospitals participating in PC4. This change appears unrelated to secular improvement trends, and likely reflects PC4's commitment to transparency and collaboration.
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