Ghanayem Nancy S, Dearani Joseph A, Welke Karl F, Béland Marie J, Shen Irving, Ebels Tjark
Department of Pediatrics, Division of Critical Care, Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, Wisconsin 53201, USA.
Cardiol Young. 2008 Dec;18 Suppl 2:240-4. doi: 10.1017/S1047951108002989.
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 Multi-Societal 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 gastrointestinal 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. Although serious gastrointestinal complications are relatively uncommon after congenital cardiac surgery, accurate estimates of the incidences of these complications are limited, in part due to lack of standardized reporting and the absence of universal nomenclature that defines organ-specific complications. The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a list of gastrointestinal complications that may be temporally associated with congenital cardiac surgery. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of 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联。并发症不一定代表构成医疗过失或医疗事故的护理标准存在失误。手术或操作并发症是指任何并发症，无论其原因如何，发生在以下情况：(1) 手术或干预（无论是否在医院内）后30天内，或 (2) 在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/操作中并发症以及术后/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与先天性心脏病患者治疗相关的一系列全面并发症，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以及胸器官移植相关的并发症。本手稿的目的是研究与胃肠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。尽管先天性心脏手术后严重的胃肠并发症相对不常见，但对这些并发症发生率的准确估计有限，部分原因是缺乏标准化报告以及缺乏定义器官特异性并发症的通用术语。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可能与先天性心脏手术在时间上相关的胃肠并发症清单。照顾先天性心脏病患者的临床医生将能够在数据库、提高质量的举措、并发症报告以及比较治疗策略中使用这份清单。
