Cardiology in the Young

Original Article

Haematological and infectious complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

Paul A. Checchiaa1 c1, Tara Karamloua2, Bohdan Maruszewskia3, Richard G. Ohyea4, Ronald Bronickia5 and Ali Dodge-Khatamia6

a1 Pediatric Cardiac Critical Care Service, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, Missouri, United States of America

a2 Division of Cardiothoracic Surgery, Oregon Health and Science University, Portland, Oregon, United States of America

a3 Department of Cardiothoracic Surgery, The Children’s Memorial Health Institute, Warsaw, Poland

a4 Section of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Michigan, United States of America

a5 Children’s Hospital of Orange County, Orange County, California, United States of America

a6 Division of Congenital Cardiovascular Surgery, University Children’s Hospital, Zürich, Switzerland

Abstract

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the haematological system and to infectious complications. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a near-exhaustive list of haematological and infectious complications. Within each subgroup, complications are presented in alphabetical order. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment.

Correspondence:

c1 Correspondence to: Paul A. Checchia, MD, Chief, Pediatric Cardiac Critical Care Service, Medical Director, Pediatric Cardiac Intensive Care Unit, St. Louis Children’s Hospital, Assistant Professor of Pediatric Critical Care and Cardiology, Washington University School of Medicine. One Children’s Place, NWT-8th Floor, St Louis, Missouri 63110, USA. Tel: 314 454 2527; Fax: 314 361 0733; E-mail: pchecchia@wustl.edu

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