Paediatric cardiology in a sub-regional cardiothoracic unit

The aim of this study was to examine the pattern of referrals the number of admissions, cardiac catheterisations and surgical procedures-including outcome-in infants and children referred to a sub-regional cardiothoracic unit during a 6-year period. The unit is served by one paediatric cardiologist and four general cardiothoracic surgeons, two of whom undertake paediatric surgery. Referrals were received from within the Trent Regional Health Authority, and from three other health Regions. During the study period 2,097 infants and children were admitted to the unit with cardiac disease, and 730 underwent cardiac surgery. The proportion of admissions undergoing surgery increased significantly with time, as did the neonatal and infant surgical procedures and infant surgical procedures. Overall, the surgical mortality did not alter with time, and was comparable to the national average. The results show an increase in the demand for cardiac investigations and surgery, and this was most evident in infants, particularly for open procedures. This unit serves a large population with proven needs, and the number of children treated falls within the range of existing supra-regional centres. The combination of available expertise, and a cost-effective patient outcome measure, should place such units in a category of high priority for resource allocation.