Management errors in adults with congenital heart disease: prevalence, sources, and consequences
| Autor: | Peter Robinson, Jens G. Kilian, Richard B. Chard, David S. Celermajer, Irina Kotchetkova, Lynne Pressley, David Tanous, Subha Nasir Ahmad, Gry Eveborn, Rachael Cordina, Julian Ayer, John E. Deanfield |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Heart Defects Congenital Male medicine.medical_specialty Heart disease Adolescent Population MEDLINE 030204 cardiovascular system & hematology 03 medical and health sciences Young Adult 0302 clinical medicine Prevalence Medicine Humans 030212 general & internal medicine Major complication Registries Young adult Disease management (health) education Aged Retrospective Studies education.field_of_study Medical Errors business.industry Disease Management Retrospective cohort study Guideline Middle Aged medicine.disease Emergency medicine Practice Guidelines as Topic Patient Compliance Female New South Wales Cardiology and Cardiovascular Medicine business Delivery of Health Care Follow-Up Studies |
| Zdroj: | European heart journal. 39(12) |
| ISSN: | 1522-9645 |
| Popis: | Aims Improved survival has resulted in increasing numbers and complexity of adults with congenital heart disease (ACHD). International guidelines recommend specialized care but many patients are still not managed at dedicated ACHD centres. This study analysed referral sources and appropriateness of management for patients referred to our tertiary ACHD Centre over the past 3 years. Methods and results We compared differences in care between patients referred from paediatric/ACHD-trained vs. general adult cardiologists, according to Adherence (A) or Non-Adherence (NA) with published guidelines. Non-Adherent cases were graded according to the severity of adverse outcome or risk of adverse outcome. Of 309 consecutively referred patients (28 ± 14 years, 51% male), 134 (43%) were from general cardiologists (19% highly complex CHD) and 115 (37%) were from paediatric cardiology or ACHD specialists (33% highly complex CHD). Sixty referrals (20%) were from other medical teams and of those, 31 had been lost to follow-up. Guideline deviations were more common in referrals from general compared to CHD-trained cardiologists (P |
| Databáze: | OpenAIRE |
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