Quality Assessment in Paediatric Cardiology: Experiences from Leveraging a Clinical Data Warehouse

Area of Science:

• Pediatric Cardiology
• Cardiac Surgery Outcomes
• Health Informatics

Background:

• Quality metrics for pediatric heart centers often use registry data.
• This study introduces an algorithm to analyze raw clinical data for mortality risk factors post-pediatric cardiac surgery.

Purpose of the Study:

• To identify significant mortality risk factors in pediatric cardiac surgery patients.
• To develop a framework for real-time analysis of raw clinical data for quality assessment and risk stratification.

Main Methods:

• Retrospective monocentric study of patients under 18 years old from 2011-2020.
• Categorization of congenital heart disease (CHD) into four groups.
• Evaluation of preoperative, demographic, periprocedural, and postsurgical risk factors.

Main Results:

• 1700 patients with 2157 hospitalizations were analyzed.
• Extracorporeal membrane oxygenation (hazard ratio 13.97), weight < 2500 g, and the creatinine ratio were significant mortality predictors.
• Patients in the univentricular heart group I also showed elevated mortality risk.

Conclusions:

• The creatinine ratio is a strong laboratory-based predictor of mortality.
• Established predictors like ECMO and low body weight are confirmed.
• The framework supports privacy-preserving, real-time quality metric assessment and risk stratification.