scholarly journals Are Outcomes in Congenital Cardiac Surgery Better Than Ever?

2021 ◽  
Author(s):  
Ryan Holcomb ◽  
Akif Ündar
Keyword(s):  
Cardiac Surgery ◽  
The United States ◽  
First Year ◽  
Long Term Effects ◽  
Congenital Cardiac Surgery ◽  
Interinstitutional Collaboration ◽  
Improved Outcomes ◽  
First Year Of Life ◽  
Modern Era ◽  
Overall Mortality

Background and Aim of the Study: Congenital heart disease is the most common congenital defect among infants born in the United States. Within the first year of life, 1 in 4 of these infants will need surgery. Only one generation removed from an overall mortality of 14%, many changes have been introduced into the field. Have these changes measurably improved outcomes? Methods: The literature search was conducted through PubMed MEDLINE and Google Scholar from inception to October 31, 2021. Ultimately, 78 publications were chosen for inclusion. Results: The outcome of overall mortality has experienced continuous improvements in the modern era of the specialty despite the performance of more technically demanding surgeries on patients with complex comorbidities. This modality does not account for case-mix, however. In turn, clinical outcomes have not been consistent from center to center. Furthermore, variation in practice between institutions has also been documented. A recurring theme in the literature is a movement towards standardization and universalization. Examples include mortality risk-stratification that has allowed direct comparison of outcomes between programs and improved definitions of morbidities which provide an enhanced framework for diagnosis and management. Conclusions: Overall mortality is now below 3%, which suggests that more patients are surviving their interventions than in any previous era in congenital cardiac surgery. Focus has transitioned from survival to improving the quality of life in the survivors by decreasing the incidence of morbidity and associated long-term effects. With the transformation towards standardization and interinstitutional collaboration, future advancements are expected.

Analysis of regional congenital cardiac surgical outcomes in Florida using The Society of Thoracic Surgeons Congenital Heart Surgery Database

2009 ◽  
Vol 19 (4) ◽  
pp. 360-369 ◽  
Author(s):  
Jeffrey P. Jacobs ◽  
James A. Quintessenza ◽  
Redmond P. Burke ◽  
Mark S. Bleiweis ◽  
Barry J. Byrne ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Quality Improvement ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Regional Analysis ◽  
The United States ◽  
Congenital Heart Surgery ◽  
Medical Services ◽  
Congenital Cardiac Surgery ◽  
Children's Medical Services

AbstractBackgroundFlorida is the fourth largest state in the United States of America. In 2004, 218,045 live babies were born in Florida, accounting for approximately 1744 new cases of congenital heart disease. We review the initial experience of The Society of Thoracic Surgeons Congenital Heart Surgery Database with a regional outcomes report, namely the Society of Thoracic Surgeons Florida Regional Report.MethodsEight centres in Florida provide services for congenital cardiac surgery. The Children’s Medical Services of Florida provide a framework for quality improvement collaboration between centres. All congenital cardiac surgical centres in Florida have voluntarily agreed to submit data to the Society of Thoracic Surgeons Database. The Society of Thoracic Surgeons and Duke Clinical Research Institute prepared a Florida Regional Report to allow detailed regional analysis of outcomes for congenital cardiac surgery.ResultsThe report of 2007 from the Society of Thoracic Surgeons Congenital Heart Surgery Database includes details of 61,014 operations performed during the 4 year data harvest window, which extended from 2003 through 2006. Of these operations, 6,385 (10.5%) were performed in Florida. Discharge mortality in the data from Florida overall, and from each Florida site, with 95% confidence intervals, is not different from cumulative data from the entire Society of Thoracic Surgeons Database, both for all patients and for patients stratified by complexity.ConclusionsA regional consortium of congenital heart surgery centres in Florida under the framework of the Children’s Medical Services has allowed for inter-institutional collaboration with the goal of quality improvement. This experience demonstrates, first, that the database maintained by the Society of Thoracic Surgeons can provide the framework for regional analysis of outcomes, and second, that voluntary regional collaborative efforts permit the pooling of data for such analysis.

PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1950 ◽  
Vol 6 (4) ◽  
pp. 673-675 ◽  
Keyword(s):  
Infant Mortality ◽  
The United States ◽  
Vital Statistics ◽  
First Year ◽  
Medical Social Work ◽  
National Office ◽  
Health Nursing ◽  
Set Up ◽  
First Year Of Life ◽  
Registration Area

CONTINUOUS decline in infant mortality has been maintained in national figures since 1936. Prior to this the preceding 20 years had witnessed a steady downward trend although there had been occasional annual interruptions. Final figures for 1948, issued by The National Office of Vital Statistics in Special Reports, Vol. 35, Number 13, p. 188, August 23, 1950, indicate a total of 113,169 deaths under 1 year of age as having [See Chart I in source pdf.] been registered in the United States. This represents a rate of 32.0 per 1,000 live births, the lowest in our history. Chart 1 indicates the trend in the "Expanding Birth Registration Area" since 1915. In that year the "Area" was set up with 10 states and the District of Columbia. In 1933, with the admission of Texas, the "Area" included all 48 states. Over the 33 year period the decline in total infant mortality has been more than two thirds. The different periods of the first year of life have not, however, shared equally in the decline. The second half of the year has had the most favorable experience with a decline of 85%, while the first day has had the least decline, less than one third.

COMPLICATIONS OF SMALLPOX VACCINATION UNITED STATES 1963

PEDIATRICS ◽  
1967 ◽  
Vol 39 (6) ◽  
pp. 916-923
Author(s):  
John M. Neff ◽  
Ronald H. Levine ◽  
J. Michael Lane ◽  
Ernest A. Ager ◽  
Helen Moore ◽  
...  
Keyword(s):  
United States ◽  
High Frequency ◽  
Primary Vaccination ◽  
The United States ◽  
Smallpox Vaccination ◽  
First Year ◽  
Common Complication ◽  
More Care ◽  
First Year Of Life

Four thousand nine hundred physicians in four states, representing 4.8% of the population of the United States, were surveyed in order to assess the frequency and types of complications that occurred during 1963 in association with smallpox vaccination. Four hundred ninety-one physicians initially reported observing 810 complications during this year. On follow-up of these cases, many were not actually complications or were complications that occurred in a year other than 1963. Accidental infection was the most common complication. Generalized vaccinia and eczema vaccinatum occurred at a frequency of 238 and 80, respectively, per million primary vaccinations. Severe complications were infrequent. No deaths and only one case each of post-vaccinal encephalitis and vaccinia necrosum were detected. The high frequency of many preventable complications and the disproportionate frequency of complications in infants suggest that morbidity and mortality now associated with smallpox vaccination could be significantly reduced if primary vaccination could be deferred until after the first year of life and if more care were taken to detect individuals in whom complications can be expected to occur.

Outcome of esophageal atresia in Germany

2020 ◽  
Author(s):  
A Schmedding ◽  
B Wittekindt ◽  
R Schloesser ◽  
M Hutter ◽  
U Rolle
Keyword(s):  
Mortality Rate ◽  
Esophageal Atresia ◽  
First Year ◽  
Insurance Company ◽  
Associated Anomalies ◽  
Clinical Registry ◽  
Major Health ◽  
First Year Of Life ◽  
Overall Mortality

Abstract The aim of this study was to evaluate the outcome of esophageal atresia in Germany in a retrospective observational study of a large cohort. Data from the major health insurance company in Germany, which covers approximately 30% of German patients, were analyzed. All patients born and registered between 2009 and 2013 with a diagnosis of esophageal atresia at first admission to the hospital were included. Mortality was analyzed during the first year of life. We identified 287 patients with esophageal atresia, including 253 with and 34 without tracheoesophageal fistula. Associated anomalies were found in 53.7% of the patients; the most frequent were cardiac anomalies (41.8%), anomalies of the urinary tract (17.4%), and atresia of the colon, rectum, and anus (9.4%). Forty-one patients (14.3%) had a birth weight <1500 g. Seventeen patients (5.9%) died before surgery. Gastrostomy was performed during the index admission in 70 patients (25.9%). The reconstruction of the esophageal passage was performed in 247 patients (93.9%). Forty-eight percent of the patients who underwent an operation required dilatation. The mortality rate in the patients who underwent an operation was 10.4%. These results from Germany correspond to the international results that have been reported. The number of dilatations was in the middle of the range of those reported in the literature; the overall mortality rate was in the upper portion of the range of the international rates. Efforts should be made to establish a clinical registry to measure and improve the quality of care for this and other rare conditions.

The Effect of Birth Month on the Risk of Respiratory Syncytial Virus Hospitalization in the First Year of Life in the United States

2014 ◽  
Vol 33 (6) ◽  
pp. e135-e140 ◽  
Author(s):  
Patricia Calderón Lloyd ◽  
Larissa May ◽  
Daniel Hoffman ◽  
Richard Riegelman ◽  
Lone Simonsen
Keyword(s):  
United States ◽  
Respiratory Syncytial Virus ◽  
The United States ◽  
First Year ◽  
Birth Month ◽  
Syncytial Virus ◽  
First Year Of Life

Long-term effects of severe undernutrition during the first year of life on brain development and learning in Chilean high-school graduates

Nutrition ◽  
2000 ◽  
Vol 16 (11-12) ◽  
pp. 1056-1063 ◽  
Author(s):  
Daniza M Ivanovic ◽  
Boris P Leiva ◽  
Hernan T Perez ◽  
Nelida B Inzunza ◽  
Atilio F Almagià ◽  
...  
Keyword(s):  
High School ◽  
Brain Development ◽  
High School Graduates ◽  
First Year ◽  
Long Term Effects ◽  
First Year Of Life

scholarly journals Competing effects on the average age of infant death

2020 ◽  
Author(s):  
Monica Alexander ◽  
Leslie Root
Keyword(s):  
Infant Mortality ◽  
Average Length ◽  
Preterm Births ◽  
The United States ◽  
Infant Mortality Rate ◽  
Approximation Formula ◽  
First Year ◽  
Black Mothers ◽  
White Mothers ◽  
First Year Of Life

In recent decades, the relationship between the average length of life for those who die in the first year of life — the lifetable quantity 1𝑎0 — and the level of infant mortality, on which its calculation is often based, has broken down. The very low levels of infant mortality in the developed world correspond to a range of 1𝑎0 quantities. We illustrate the competing effect of falling mortality and reduction in preterm births on 1𝑎0, through two populations with very different levels of premature birth — infants born to non-Hispanic white mothers and to non- Hispanic black mothers in the United States. Through simulation, we further demonstrate that falling mortality reduces 1𝑎0, while a reduction in premature births increases it. We use these observations to motivate the formulation of a new approximation formula for 1𝑎0 in low- mortality contexts, which is a function of both the infant mortality rate and the ratio of infant to under-five mortality. Model results and validation show that this model outperforms existing alternatives.

INFANT MORTALITY RATES FOR THE TOWN OF SALEM, MASSACHUSETTS, IN 1782 AND 1783

PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 800-800
Author(s):  
T. E. C.
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Infant Mortality ◽  
New England ◽  
The United States ◽  
Infant Mortality Rate ◽  
First Year ◽  
True Index ◽  
First Year Of Life ◽  
The Town

The infant mortality rate for a single New England town for the years 1782 and 1783 cannot be used as a true index of this statistic for the 13 states which made up the United States during the 1780's. As we lack data concerning infant mortality for the country as a whole during this period, information about the mortality of infants in the town of Salem, Massachusetts, where all births were recorded, should be of interest to pediatricians. Doctor Edward A. Holyoke of Salem in a letter to Mr. Caleb Garnett, the Recording Secretary of the American Academy of Arts and Sciences, gave these figures for the town of Salem: In 1782 there were 311 live-born infants and of these 36 died before they reached their first birthday, for an infant mortality rate of 115. In 1783 of 374 live-born infants, 38 died during their first year of life, for an infant mortality of 102. When one recalls that the rate for 1915 in the United States was 100, the infants, at least in Salem, did not fare too badly.

Sign in / Sign up

Export Citation Format

Share Document