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Evaluation of paediatric cardiosurgical model in Croatia by using the Aristotle basic complexity score and the risk adjustment for congenital cardiac surgery-1 method

Published online by Cambridge University Press:  22 March 2010

Daniel Dilber*
Affiliation:
Department of Pediatrics, Division of Cardiology, University Hospital Zagreb, Medical School of Zagreb, Croatia
Ivan Malcic
Affiliation:
Department of Pediatrics, Division of Cardiology, University Hospital Zagreb, Medical School of Zagreb, Croatia
*Corresponding
Correspondence to: Daniel Dilber, Department of Pediatrics, Division of Cardiology, University Hospital Zagreb, Medical School of Zagreb, Kišpatićeva 12, Croatia. Tel: +38512367589; Fax: +38512421894; E-mail: dilber_daniel@yahoo.com

Abstract

Objective

The Aristotle basic complexity score and the risk adjustment in congenital cardiac surgery-1 method were developed and used to compare outcomes of congenital cardiac surgery. Both methods were used to compare results of procedures performed on our patients in Croatian cardiosurgical centres and results of procedures were taken abroad.

Methods

The study population consisted of all patients with congenital cardiac disease born to Croatian residents between 1 October, 2002 and 1 October, 2007 undergoing a cardiovascular operation during this period.

Results

Of the 556 operations, the Aristotle basic complexity score could be assigned to 553 operations and the risk adjustment in congenital cardiac surgery-1 method to 536 operations. Procedures were performed in two institutions in Croatia and seven institutions abroad. The average complexity for cardiac procedures performed in Croatia was significantly lower. With both systems, along with the increase in complexity, there is also an increase in mortality before discharge and postoperative length of stay. Only after the adjustment for complexity there are marked differences in mortality and occurrence of postoperative complications.

Conclusion

Both, the Aristotle basic complexity score and the risk adjustment in congenital cardiac surgery-1 method were predictive of in-hospital mortality as well as prolonged postoperative length to stay, and can be used as a tool in our country to evaluate a cardiosurgical model and recognise potential problems.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

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