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与小儿心脏手术相关的重要早期并发症的定义。

Definition of important early morbidities related to paediatric cardiac surgery.

作者信息

Brown Katherine L, Pagel Christina, Brimmell Rhian, Bull Kate, Davis Peter, Franklin Rodney C, Hoskote Aparna, Khan Natasha, Rodrigues Warren, Thorne Sara, Smith Liz, Chigaru Linda, Utley Martin, Wray Jo, Tsang Victor, Mclean Andrew

机构信息

1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.

2Clinical Operational Research Unit,University College London,London,United Kingdom.

出版信息

Cardiol Young. 2017 May;27(4):747-756. doi: 10.1017/S1047951116001256. Epub 2016 Sep 29.

Abstract

BACKGROUND

Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance.

METHODS

As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients.

RESULTS

We present a set of definitions of morbidity for use in routine audit after paediatric cardiac surgery. These morbidities are ranked in priority order as acute neurological event, unplanned re-operation, feeding problems, the need for renal support, major adverse cardiac events or never events, extracorporeal life support, necrotising enterocolitis, surgical site of blood stream infection, and prolonged pleural effusion or chylothorax. It is recognised that more than one such morbidity may arise in the same patient and these are referred to as multiple morbidities, except in the case of extracorporeal life support, which is a stand-alone constellation of morbidity.

CONCLUSIONS

It is feasible to define a range of paediatric cardiac surgical morbidities for use in routine audit that reflects the priorities of both professionals and parents. The impact of these morbidities on the patient and family will be explored prospectively as part of a wider ongoing, multi-centre study.

摘要

背景

发病率被定义为不健康的状态或经历一种“总体上对你有害”的健康状况,与小儿心脏手术相关的术后发病率包括一系列可能影响患者的情况,这些情况是质量保证的潜在目标。

方法

作为一项更广泛研究的一部分,一个多学科专业团队旨在确定一份与小儿心脏手术相关的发病率清单,该清单由一个小组进行优先级排序,该小组反映了来自不同学科和背景的专业人员以及家长和患者的意见。

结果

我们提出了一组小儿心脏手术后用于常规审计的发病率定义。这些发病率按优先级顺序排列为急性神经事件、计划外再次手术、喂养问题、肾脏支持需求、重大不良心脏事件或严重不良事件、体外生命支持、坏死性小肠结肠炎、手术部位血流感染以及长期胸腔积液或乳糜胸。人们认识到,同一患者可能会出现不止一种此类发病率,这些被称为多种发病率,但体外生命支持情况除外,它是一种独立的发病率组合。

结论

定义一系列用于常规审计的小儿心脏手术发病率是可行的,这些发病率反映了专业人员和家长的优先事项。作为一项正在进行的更广泛的多中心研究的一部分,将前瞻性地探讨这些发病率对患者和家庭的影响。

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