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儿童先天性心脏缺陷手术后的死亡率和外科医生的表现
J Stark1, S Gallivan, J Lovegrove
1Institute of Child Health, London, UK. jarda@freeuk.com
Lancet (London, England)
|April 18, 2000
概括
这项研究跟踪了英国儿科先天性心脏缺陷手术的死亡率. 虽然整体死亡率为4.0%,但每位外科医生患者数量少,阻碍了绩效评估.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 公共卫生 公共卫生
背景情况:
- 一项公共调查强调了在儿科先天性心脏缺陷 (CHD) 手术中需要可靠的死亡率数据.
- 评估个体外科医生的表现需要关于整体死亡率的可靠数据.
研究的目的:
- 收集和报告一年以上儿科心脏病手术的死亡率数据.
- 为临床医生,研究人员,政策制定者和公众提供必要的信息.
主要方法:
- 收集了英国五个省份1378次先天性心脏缺陷手术的数据 (1997年4月至1998年3月).
- 在研究期间,手术占英国所有手术的约36%.
- 使用商定的标准将业务分为不同的子组.
主要成果:
- 所有手术的整体死亡率为4.0% (95% CI 3.0-5.2).
- 具体的死亡率因手术而异,动脉切换手术的死亡率为0%,动脉断层手术的死亡率为28.6%.
- 外科医生死亡率在1.6%至6.9%之间,但较少的病例数量限制了检测显著绩效差异的能力.
结论:
- 参与的部门表现出了对儿科慢性心血管疾病的高标准护理.
- 由于复杂的缺陷和小患者子组,评估个体外科医生的表现具有挑战性.
- 较大的多中心数据集是强有力的质量标准和绩效评估所必需的.
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