Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • Log out

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Log out
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

In-Hospital Mortality for Surgical Repair of Congenital Heart Defects: Preliminary Observations of Variation by Hospital Caseload

Kathy J. Jenkins, Jane W. Newburger, James E. Lock, Roger B. Davis, Gerald A. Coffman and Lisa I. Iezzoni
Pediatrics March 1995, 95 (3) 323-330;
Kathy J. Jenkins
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jane W. Newburger
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James E. Lock
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Roger B. Davis
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gerald A. Coffman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lisa I. Iezzoni
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • Comments
Loading
Download PDF

Abstract

Objective. To examine the impact of hospital caseload on in-hospital mortality for pediatric congenital heart surgery.

Design. Population-based, retrospective cohort study.

Setting. Acute care hospitals in California and Massachusetts.

Patients. Children undergoing surgery for congenital heart disease, identified by the presence of procedure codes indicating surgical repair of a congenital heart defect in computerized statewide hospital discharge abstract databases. Cases were grouped into four categories based on the complexity of the procedure.

Main outcome measures. Adjusted odds ratios (OR) for in-hospital death were estimated using generalized estimating equations that account for the intra-institutional correlation among patients.

Results. A total of 2833 cases at 37 centers were identified. Compared with centers performing >300 cases per year, after controlling for patient characteristics, centers performing <10 cases per year had an OR for in-hospital death of 7.7 (95% confidence interval (CI) [1.6-37.8]); 10 to 100 cases, OR = 2.9 (95% CI [1.6-5.3]); 101 to 300 cases, OR = 3.0 (95% CI [1.8-4.9]). Independent risk factors for mortality included procedure complexity category (P < .0001), use of cardiopulmonary bypass (P < .0001), young age at surgery (P = .001), and transfer from another acute care hospital (P < .0001). Few differences were found by hospital caseload in length of stay or total hospital charges.

Conclusions. For children with a congenital heart defect who underwent surgery in California in 1988 or Massachusetts in 1989, the risk of dying in-hospital was much lower if the surgery was performed at an institution performing >300 cases annually. This study was limited by the absence of clinical detail in discharge abstract databases. If these findings are corroborated by other studies, health care delivery strategies that direct children requiring surgical correction of congenital heart defects to high-volume centers may substantially reduce overall mortality.

  • Received August 24, 1994.
  • Accepted December 29, 1994.
  • Copyright © 1995 by the American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 95, Issue 3
1 Mar 1995
  • Table of Contents
  • Index by author
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
In-Hospital Mortality for Surgical Repair of Congenital Heart Defects: Preliminary Observations of Variation by Hospital Caseload
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
In-Hospital Mortality for Surgical Repair of Congenital Heart Defects: Preliminary Observations of Variation by Hospital Caseload
Kathy J. Jenkins, Jane W. Newburger, James E. Lock, Roger B. Davis, Gerald A. Coffman, Lisa I. Iezzoni
Pediatrics Mar 1995, 95 (3) 323-330;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
In-Hospital Mortality for Surgical Repair of Congenital Heart Defects: Preliminary Observations of Variation by Hospital Caseload
Kathy J. Jenkins, Jane W. Newburger, James E. Lock, Roger B. Davis, Gerald A. Coffman, Lisa I. Iezzoni
Pediatrics Mar 1995, 95 (3) 323-330;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Optimizing Resources in Childrens Surgical Care: An Update on the American College of Surgeons' Verification Program
  • Congenital Heart Defects: Amazing Advances and Ongoing Challenges
  • Development and Validation of an Agency for Healthcare Research and Quality Indicator for Mortality After Congenital Heart Surgery Harmonized With Risk Adjustment for Congenital Heart Surgery (RACHS-1) Methodology
  • Increased Survival of Congenital Heart Disease: How Did We Get Here and Now What?
  • Variation in Use of Pediatric Cardiology Subspecialty Care: A Total Population Study in California, 1983 to 2011
  • Improvement in Interstage Survival in a National Pediatric Cardiology Learning Network
  • Medical Staff Appointment and Delineation of Pediatric Privileges in Hospitals
  • Association of Center Volume With Mortality and Complications in Pediatric Heart Surgery
  • Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals: Risk Factors for High Resource Utilization and Association With Inpatient Death
  • Risk Factors for Death After Adult Congenital Heart Surgery in Pediatric Hospitals
  • Neonatal Heart Surgery: Evaluation of Risk Factors
  • Preliminary Assessment of Pediatric Health Care Quality and Patient Safety in the United States Using Readily Available Administrative Data
  • Charges and Lengths of Stay Attributable to Adverse Patient-Care Events Using Pediatric-Specific Quality Indicators: A Multicenter Study of Freestanding Children's Hospitals
  • Improvement in Congenital Heart Surgery in a Developing Country: The Guatemalan Experience
  • Case Load and Mortality in Pediatric Cardiac Surgery
  • Case Volume and Mortality in Pediatric Cardiac Surgery Patients in California, 1998-2003
  • Reevaluation of the Volume-Outcome Relationship for Pediatric Cardiac Surgery
  • Changes in Hospitalization Patterns Among Patients With Congenital Heart Disease During the Transition From Adolescence to Adulthood
  • Pretransport and Posttransport Characteristics and Outcomes of Neonates Who Were Admitted to a Cardiac Intensive Care Unit
  • Variations in Management of Common Inpatient Pediatric Illnesses: Hospitalists and Community Pediatricians
  • In-Hospital Mortality for Children With Hypoplastic Left Heart Syndrome After Stage I Surgical Palliation: Teaching Versus Nonteaching Hospitals
  • Lengths of Stay and Costs Associated With Children's Hospitals
  • Levels of Neonatal Care
  • The Effect of Hospital Volume of Pediatric Appendectomies on the Misdiagnosis of Appendicitis in Children
  • Risk Adjustment for Pediatric Quality Indicators
  • Evidence-Based Referral Results in Significantly Reduced Mortality After Congenital Heart Surgery
  • Using routine comparative data to assess the quality of health care: understanding and avoiding common pitfalls
  • Outcomes Research in Pediatric Settings: Recent Trends and Future Directions
  • Can Regionalization Decrease the Number of Deaths for Children Who Undergo Cardiac Surgery? A Theoretical Analysis
  • Female Sex as a Risk Factor for In-Hospital Mortality Among Children Undergoing Cardiac Surgery
  • Medical Staff Appointment and Delineation of Pediatric Privileges in Hospitals
  • Guidelines for Pediatric Cardiovascular Centers
  • Mortality and volume of cases in paediatric cardiac surgery: retrospective study based on routinely collected data
  • Can Regionalization Decrease the Number of Deaths for Children Who Undergo Cardiac Surgery? A Theoretical Analysis
  • Impact of Telemedicine on the Practice of Pediatric Cardiology in Community Hospitals
  • The Impact of Managed Care Insurance on Use of Lower-Mortality Hospitals by Children Undergoing Cardiac Surgery in California
  • Factors Associated With Age at Operation for Children With Congenital Heart Disease
  • Pediatric Cardiac Surgery: The Effect of Hospital and Surgeon Volume on In-hospital Mortality
  • Serum lactate as a predictor of mortality after paediatric cardiac surgery
  • Hospital and Patient Characteristics Associated With Variation in 28-Day Mortality Rates for Very Low Birth Weight Infants
  • Google Scholar

More in this TOC Section

  • Nurse Home Visiting and Maternal Mental Health: 3-Year Follow-Up of a Randomized Trial
  • Neighborhood Child Opportunity Index and Adolescent Cardiometabolic Risk
  • Neonates Born to Mothers With COVID-19: Data From the Spanish Society of Neonatology Registry
Show more Articles

Similar Articles

  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics