title: Mortality as a measure of quality of care in infants with congenital cardiovascular malformations following surgery.
abstract: BACKGROUND
  Mortality has traditionally been perceived as a straightforward measure of outcome and has been used to evaluate surgical performance. In the rapidly developing arena of paediatric cardiac surgery, the insightful analysis of mortality figures is challenging.
  
  
  METHODS
  This report discusses the issues involved when mortality is used as a marker for surgical outcome, referring to national and international audit and research data.
  
  
  RESULTS
  Mortality is an important variable and should be transparently defined, reported and monitored.
  
  
  RESULTS
  Definitions of mortality, assessments of risk and interpretations of reported statistics all have limitations that must be recognized.
  
  
  CONCLUSIONS
  Traditional use of raw early mortality as a simplistic indicator of outcome and performance is evolving to include risk-adjusted mortality, longer-term survival, reinterventions and complications.
  
  
  CONCLUSIONS
  As the vast majority of children undergoing cardiac surgery now survive beyond 30 days, the focus for measures of quality is shifting towards morbidity.
authors: Cardiac Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.
authors: Hanna A
authors: HA
authors: Jensen
authors: Cardiac Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.
authors: Katherine L
authors: KL
authors: Brown
authors: Clinical Operational Research Unit, University College London, 4 Taviton Street, London WC1H 0BT, UK.
authors: Christina
authors: C
authors: Pagel
authors: Cardiac Surgery Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
authors: David J
authors: DJ
authors: Barron
authors: Paediatric Cardiology Directorate, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK National Institute for Cardiovascular Outcomes Research, 170 Tottenham Court Road, London W1T 7NU, UK r.franklin@rbht.nhs.uk.
authors: Rodney C G
authors: RC
authors: Franklin
mesh_terms: D006348:Cardiac Surgical Procedures / Q000401:mortality* / Q000592:standards; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D011787:Quality of Health Care; D020379:Risk Adjustment / Q000379:methods; D006113:United Kingdom / Q000453:epidemiology
keywords: congenital heart disease; mortality; quality of care