Lundström N R, Berggren H, Björkhem G, Jögi P, Sunnegârdh J
Department of Pediatrics, University Hospital, SE-221 85 Lund, Sweden.
Pediatr Cardiol. 2000 Jul-Aug;21(4):353-7. doi: 10.1007/s002460010079.
In Sweden, which has a population of 8.9 million people, pediatric heart surgery was previously performed in four cities. After a long, difficult process, centralization of pediatric heart surgery to two centers was achieved in 1993. The overall 30-day mortality for open-heart surgery on infants and children of 9.5% before the centralization (1988-1991) was reduced to 1.9% in 1995-1997. A causal relationship between the mortality rates before and after the centralization is impossible to prove. Heart surgery was concentrated to the two centers with the lowest surgical mortality, and the reduction in surgical mortality was observed over a short period of time which makes it likely that the centralization of the surgical activity promoted the improved results. During the later time period the amount of more complex surgery was clearly increased compared to that performed previously.
瑞典有890万人口，此前小儿心脏手术在4个城市进行。经过漫长而艰难的过程，1993年小儿心脏手术集中到了两个中心。集中化之前（1988 - 1991年）婴儿和儿童心脏直视手术的总体30天死亡率为9.5%，1995 - 1997年降至1.9%。集中化前后死亡率之间的因果关系无法证明。心脏手术集中到了手术死亡率最低的两个中心，并且手术死亡率在短时间内就有所下降，这使得手术活动的集中化很可能促进了结果的改善。在后期，与之前相比，更复杂手术的数量明显增加。
