Bacha Emile Antoine, Cooper David, Thiagarajan Ravi, Franklin Rodney C G, Krogmann Otto, Deal Barbara, Mavroudis Constantine, Shukla Avinash, Yeh Thomas, Barach Paul, Wessel David, Stellin Giovanni, Colan Steven D
Department of Cardiac Surgery, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts 02115, USA.
Cardiol Young. 2008 Dec;18 Suppl 2:196-201. doi: 10.1017/S1047951108002928.
A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the cardiac system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a near-exhaustive list of cardiac complications, including intraoperative complications and cardiopulmonary bypass-related complications. These cardiac complications are presented in the following subgroups: 1) Cardiac (general), 2) Cardiac--Metabolic, 3) Cardiac--Residual and Recurrent cardiac lesions, 4) Arrhythmia, 5) Cardiopulmonary bypass and mechanical circulatory support, and 6) Operative/Procedural. Within each subgroup, complications are presented in alphabetical order. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment.
并发症是与疾病或医疗干预相关的事件或情况，偏离了预期的事件进程，可能导致或与次优结果相关。并发症不一定代表构成医疗过失或医疗事故的医疗护理标准存在问题。手术或操作并发症是指任何并发症，无论其原因如何，发生在（1）手术后或医院内外干预后30天内，或（2）手术或干预后的同一住院期间30天后。在此时间间隔内，手术和操作并发症包括术中/操作中并发症和术后/操作后并发症。小儿和先天性心脏病多学会数据库委员会已经列出了一份与先天性心脏病患者治疗相关的并发症综合清单，涉及心脏、肺、肾、血液、感染、神经、胃肠和内分泌系统，以及与麻醉和灌注管理、胸器官移植相关的并发症。本手稿的目的是研究与心脏系统具体相关的手术发病率定义。这些具体定义和术语将用于以通用语言在许多独立数据库中跟踪与手术和经导管干预及其他治疗形式相关的发病率。小儿和先天性心脏病多学会数据库委员会已经编制并定义了一份几乎详尽的心脏并发症清单，包括术中并发症和与体外循环相关的并发症。这些心脏并发症分为以下亚组：1）心脏（一般），2）心脏 - 代谢，3）心脏 - 残余和复发性心脏病变，4）心律失常，5）体外循环和机械循环支持，6）手术/操作。在每个亚组中，并发症按字母顺序排列。照顾先天性心脏病患者的临床医生将能够将此清单用于数据库、质量改进计划、并发症报告以及比较治疗策略。
