Authors (including presenting author) :
Au WKT, Rocha BA, Yam N and Bhatia I
Affiliation :
Department of Cardiothoracic surgery, Queen Mary Hospital
Introduction :
QMH is the only hospital in Hong Kong specializing in pediatric cardiac surgery. Since congenital cardiac surgery varies in complexity, the evaluation of outcomes becomes very challenging. Comprehensive data collection and analysis is essential for monitoring outcomes and continued quality improvement.
Objectives :
Databases and registries are important in evaluating the outcomes and comparing them to national and international standards. To this end, the department of cardiothoracic surgery regularly reports case complexity profile, mortality and complications to European Congenital Heart Surgeons Association (ECHSA) for registry and benchmarking purposes. ECHSA congenital database is a high-quality surgical outcomes database that measures risk-adjusted outcomes of congenital cardiac surgical interventions.Here we review the last seven years’ data and summarize the results.
Methodology :
From 2012 to Oct 2018 a total of 2368 congenital cardiac surgeries in 1808 patients have been submitted to ECHSA database. Data reported to the database included basic demographic information, anatomic diagnoses, associated non-cardiac abnormalities, preoperative risk factors, intraoperative data, type of surgical procedure, and postoperative complications, as well as hospital and 30-day mortality.
Result & Outcome :
A total of 2368 congenital cardiac surgeries were performed in 1808 patients. Since 2013, when the ban was imposed on Mainland Chinese women giving birth in Hong Kong, the volume of congenital cardiac surgery has reduced by 10% annually. Both at QMH and ECHSA database nearly 50% of the surgeries were performed in children less than 1 year of age and at QMH 15% of these had a previous cardiac surgery done. Adult congenital surgery also contributed to a considerable chunk of the workload, 12% at QMH vs 8% in ECHSA. At QMH 63% were open heart surgeries vs 35.6% in the database. The most frequently performed procedure at QMH as well as in the ECHSA database was VSD with 30-day mortality of 0.26% vs 0.71% respectively. Overall, 30-day mortality at QMH was 2.21% vs 3.9 % in ECHSA database. Conclusion
The ECHSA database allowed examination and benchmarking of our congenital cardiac surgery outcomes to international standards and provided risk-adjusted surgical outcome measures that can be used for performance improvement of surgical mortality and morbidity. Mortality at QMH was lower than that reported in the ECHSA database. These figures are an attestation of the quality of service we provide to our patients and our commitment to quality improvement.
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