Walters Henry L, Jeffries Howard E, Cohen Gordon A, Klitzner Thomas
Department of Cardiovascular Surgery, Children's Hospital of Michigan, Detroit, Michigan 48201, USA.
Cardiol Young. 2008 Dec;18 Suppl 2:245-55. doi: 10.1017/S1047951108003016.
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 a collection of loosely related topics that include the following groups of complications: 1) Complications of the Integument, 2) Complications of the Vascular System, 3) Complications of the Vascular-Line(s), 4) Complications of Wounds. 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. As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. 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。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的违反。手术或操作并发症是指任何并发症，无论原因如何，发生在（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/操作中并发症和术后/操作后并发症。儿科和先天性心脏病多学会数据库委员会列出了与先天性心脏病患者治疗相关的一系列并发症，涉及心脏、肺、肾、血液、感染性、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手术发病率的定义，这些定义具体涉及一组松散相关的主题，包括以下几组并发症：1）皮肤并发症，2）血管系统并发症，3）血管通路并发症，4）伤口并发症。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。近年来，随着先天性心脏病患儿手术生存率的提高，重点必然转向降低先天性心脏畸形及其治疗的发病率。本文列出了一份全面的并发症清单。该清单是基于系统的并发症纲要的一部分，将规范术语，从而使先天性心脏畸形患者的发病率研究和量化成为可能。治疗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、提高质量的倡议、并发症报告以及比较治疗策略。
