title: Use of diagnostic information submitted to the United Kingdom Central Cardiac Audit Database: development of categorisation and allocation algorithms.
abstract: OBJECTIVE
  To categorise records according to primary cardiac diagnosis in the United Kingdom Central Cardiac Audit Database in order to add this information to a risk adjustment model for paediatric cardiac surgery.
  
  
  METHODS
  Codes from the International Paediatric Congenital Cardiac Code were mapped to recognisable primary cardiac diagnosis groupings, allocated using a hierarchy and less refined diagnosis groups, based on the number of functional ventricles and presence of aortic obstruction.
  
  
  METHODS
  A National Clinical Audit Database. Patients Children undergoing cardiac interventions: the proportions for each diagnosis scheme are presented for 13,551 first patient surgical episodes since 2004.
  
  
  RESULTS
  In Scheme 1, the most prevalent diagnoses nationally were ventricular septal defect (13%), patent ductus arteriosus (10.4%), and tetralogy of Fallot (9.5%). In Scheme 2, the prevalence of a biventricular heart without aortic obstruction was 64.2% and with aortic obstruction was 14.1%; the prevalence of a functionally univentricular heart without aortic obstruction was 4.3% and with aortic obstruction was 4.7%; the prevalence of unknown (ambiguous) number of ventricles was 8.4%; and the prevalence of acquired heart disease only was 2.2%. Diagnostic groups added to procedural information: of the 17% of all operations classed as "not a specific procedure", 97.1% had a diagnosis identified in Scheme 1 and 97.2% in Scheme 2.
  
  
  CONCLUSIONS
  Diagnostic information adds to surgical procedural data when the complexity of case mix is analysed in a national database. These diagnostic categorisation schemes may be used for future investigation of the frequency of conditions and evaluation of long-term outcome over a series of procedures.
authors.affiliation: Cardiac Unit, Great Ormond Street Hospital NHS Trust, London, United Kingdom.
authors.forename: Kate L
authors.initials: KL
authors.lastname: Brown
authors.forename: Sonya
authors.initials: S
authors.lastname: Crowe
authors.forename: Christina
authors.initials: C
authors.lastname: Pagel
authors.forename: Catherine
authors.initials: C
authors.lastname: Bull
authors.forename: Nagarajan
authors.initials: N
authors.lastname: Muthialu
authors.forename: John
authors.initials: J
authors.lastname: Gibbs
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.forename: Martin
authors.initials: M
authors.lastname: Utley
authors.forename: Victor T
authors.initials: VT
authors.lastname: Tsang
authors.forename: Rodney
authors.initials: R
authors.lastname: Franklin
mesh_terms: D000293:Adolescent; D000465:Algorithms; D006348:Cardiac Surgical Procedures / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004374:Ductus Arteriosus, Patent / Q000145:classification / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006330:Heart Defects, Congenital / Q000145:classification / Q000453:epidemiology / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000145:classification / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D015995:Prevalence; D011785:Quality Assurance, Health Care / Q000379:methods*; D018570:Risk Assessment; D013771:Tetralogy of Fallot / Q000145:classification / Q000453:epidemiology / Q000601:surgery; D006113:United Kingdom / Q000453:epidemiology