Definition of important early morbidities related to paediatric cardiac surgery.
BACKGROUND
Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance.


METHODS
As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients.


RESULTS
We present a set of definitions of morbidity for use in routine audit after paediatric cardiac surgery. These morbidities are ranked in priority order as acute neurological event, unplanned re-operation, feeding problems, the need for renal support, major adverse cardiac events or never events, extracorporeal life support, necrotising enterocolitis, surgical site of blood stream infection, and prolonged pleural effusion or chylothorax. It is recognised that more than one such morbidity may arise in the same patient and these are referred to as multiple morbidities, except in the case of extracorporeal life support, which is a stand-alone constellation of morbidity.


CONCLUSIONS
It is feasible to define a range of paediatric cardiac surgical morbidities for use in routine audit that reflects the priorities of both professionals and parents. The impact of these morbidities on the patient and family will be explored prospectively as part of a wider ongoing, multi-centre study.
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Katherine L
KL
Brown
2Clinical Operational Research Unit,University College London,London,United Kingdom.
Christina
C
Pagel
3Department Paediatric Cardiology and Cardiac Surgery,Evelina London Children's Hospital,London,United Kingdom.
Rhian
R
Brimmell
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Kate
K
Bull
4Paediatric Intensive Care Unit,Bristol Royal Hospital for Children,Bristol,United Kingdom.
Peter
P
Davis
5Paediatric Cardiology Department,Royal Brompton and Harefield NHS Foundation Trust,London,United Kingdom.
Rodney C
RC
Franklin
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Aparna
A
Hoskote
6Department of Cardiac Surgery,Birmingham Children's Hospital,Birmingham,United Kingdom.
Natasha
N
Khan
7Departments of Paediatric Intensive Care and Paediatric Cardiac Surgery,Royal Hospital for Children at Yorkhill,Glasgow,United Kingdom.
Warren
W
Rodrigues
8Department of Cardiology,University Hospital Birmingham,Birmingham,United Kingdom.
Sara
S
Thorne
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Liz
L
Smith
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Linda
L
Chigaru
2Clinical Operational Research Unit,University College London,London,United Kingdom.
Martin
M
Utley
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Jo
J
Wray
1Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Victor
V
Tsang
7Departments of Paediatric Intensive Care and Paediatric Cardiac Surgery,Royal Hospital for Children at Yorkhill,Glasgow,United Kingdom.
Andrew
A
Mclean
D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D002648:Child; D032921:Consensus; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D009017:Morbidity; D010372:Pediatrics; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology*; D011785:Quality Assurance, Health Care; D012955:Societies, Medical; D006113:United Kingdom
Morbidity; complication; outcome; paediatric cardiac surgery