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High-Volume Medical Centers Do Better Job Managing Complications in Children Having Heart Surgery


Studies have found that children having heart surgery fare better at medical centers that perform a high volume of procedures, but data have been limited on which factors contribute to the better outcomes.

A new study, "Association of Center Volume With Mortality and Complications in Pediatric Heart Surgery," in the February 2012 Pediatrics (published online Jan. 9), found that the higher mortality observed at lower volume centers appears to be related to a higher rate of death in those with postoperative complications, rather than a higher rate of complications alone. Overall, out of more than 35,000 pediatric heart surgery patients studied, 3.9 percent died in-hospital, and 40.6 percent had at least one postoperative complication. In the group of patients who suffered a complication, the overall mortality rate was 9.0 percent. High- and low-volume centers had similar rates of postoperative complications. However, for patients who suffered a complication, medical centers performing fewer than 150 cases per year had a rate of death 1.6 times higher than medical centers that performed more than 350 cases per year. There has been a general focus on reducing postoperative complications as a means to improve outcomes in both children and adults undergoing a variety of surgical procedures. Study authors conclude that initiatives to improve patient outcomes must focus not only on reducing complications themselves, but on improving recognition and management of complications once they occur.

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The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.