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.
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.