Results of international assistance for a paediatric heart surgery programme in a single Ukrainian centre
| Autor: | Mark H.D. Danton, Sri O. Rao, Jamie Penk, John P. Breinholt, Ali Dodge-Khatami, William M. Novick, Frank Molloy, Igor V. Polivenok, Marcelo Cardarelli, Christian L. Gilbert |
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| Rok vydání: | 2019 |
| Předmět: |
Heart Defects
Congenital medicine.medical_specialty International Cooperation medicine Humans Hospital Mortality Cardiac Surgical Procedures Program Development Surgical assistance Retrospective Studies Patient Care Team Case volume Health professionals business.industry Operative mortality Thoracic Surgery General Medicine Risk adjustment Hospitals Pediatric Confidence interval Surgery Survival Rate Standardized mortality ratio Pediatrics Perinatology and Child Health Risk Adjustment Ukraine Cardiology and Cardiovascular Medicine Soviet union business |
| Zdroj: | Cardiology in the Young. 29:363-368 |
| ISSN: | 1467-1107 1047-9511 |
| Popis: | BackgroundSurgery for CHD has been slow to develop in parts of the former Soviet Union. The impact of an 8-year surgical assistance programme between an emerging centre and a multi-disciplinary international team that comprised healthcare professionals from developed cardiac programmes is analysed and presented.Material and methodsThe international paediatric assistance programme included five main components – intermittent clinical visits to the site annually, medical education, biomedical engineering support, nurse empowerment, and team-based practice development. Data were analysed from visiting teams and local databases before and since commencement of assistance in 2007 (era A: 2000–2007; era B: 2008–2015). The following variables were compared between periods: annual case volume, operative mortality, case complexity based on Risk Adjustment for Congenital Heart Surgery (RACHS-1), and RACHS-adjusted standardised mortality ratio.ResultsA total of 154 RACHS-classifiable operations were performed during era A, with a mean annual case volume by local surgeons of 19.3 at 95% confidence interval 14.3–24.2, with an operative mortality of 4.6% and a standardised mortality ratio of 2.1. In era B, surgical volume increased to a mean of 103.1 annual cases (95% confidence interval 69.1–137.2, pConclusionsThe model of assistance described in this report led to improved adjusted mortality, increased case volume, complexity, and independent operating skills. |
| Databáze: | OpenAIRE |
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