How to Report postoperative pediatric cardiac surgery? Review and analysis of the literature

Introduction

Since the disqualification of mortality as unique quality outcome after pediatric cardiac surgery, many quality outcomes have been proposed without any universal agreement.

Objective

To list the most used quality outcomes from a literature review and to analyze the behavior of these quality outcomes.

Methods

The study was restricted to Arterial Switch Operation (ASO) and Ventricular Septal Defects Closure (VSDC). Three criteria were used to qualify the quality outcomes: variation in time, variation between centers, and dependency on surgical severity. The analysis was performed using data extracted from an extensive review of the literature and from our local database. The categorial outcomes were automaticaly classified by a grouping algorithm. All the outcomes significantly described in the litterature were clustered. Programmation was performed in R.

Results/Expected results

The literature review identified 41 articles discussing quality outcomes of pediatric cardiac surgery. 18 quality outcomes were extracted. In total, 15 centers were found to have reported surgery early outcomes (nine for ASO and six for VSDC). The outcomes clusterisation is presented in Figure 1.

Conclusion/Perspectives

Three groups of outcomes were identified: 1/ Medical Hazards (mortality, resuscitation, extra corporeal membrane oxygenation, neurological events, atrio-ventricular block), 2/Expected events and preventive strategies (renal support, effusion, delayed sternal closure, length of stays, durations of amine/ventilation) and 3/ unwanted adverse events (reintervention/readmission, infectious event, reintubation). This list of outcomes could be used as a standard base for future reports.