In-hospital mortality for surgical repair of congenital heart defects : preliminary observations of variation by hospital caseload.
To examine the impact of hospital caseload on in-hospital mortality for pediatric congenital heart surgery.
Population-based, retrospective cohort study.
Acute care hospitals in California and Massachusetts.
Children undergoing surgery for congenital heart disease, identified by the presence of procedure codes indicating surgical repair of a congenital heart defect in computerized statewide hospital discharge abstract databases.
Cases were grouped into four categories based on the complexity of the procedure.
Main outcome measures
Adjusted odds ratios (OR) for in-hospital death were estimated using generalized estimating equations that account for the intra-institutional correlation among patients.
A total of 2833 cases at 37 centers were identified.
Compared with centers performing>300 cases per year, after controlling for patient characteristics, centers performing<10 cases per year had an OR for in-hospital death of 7.7 (95% confidence interval (CI) [1.6-37.8]) ; 10 to 100 cases, OR=2.9 (95% CI [1.6-5.3]) ; 101 to 300 cases, OR=3.0 (95% CI [1.8-4.9]).
Mots-clés Pascal : Cardiopathie, Congénital, Enfant, Homme, Epidémiologie, Mortalité, Milieu hospitalier, Postopératoire, Estimation paramètre, Californie, Etats Unis, Amérique du Nord, Amérique, Massachusetts, Appareil circulatoire pathologie, Maladie congénitale
Mots-clés Pascal anglais : Heart disease, Congenital, Child, Human, Epidemiology, Mortality, Hospital environment, Postoperative, Parameter estimation, California, United States, North America, America, Massachusetts, Cardiovascular disease, Congenital disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0210439
Code Inist : 002B12A08. Création : 09/06/1995.