Results of international assistance for a paediatric heart surgery programme in a single Ukrainian centre.
Cardiol Young
; 29(3): 363-368, 2019 Mar.
Article
in En
| MEDLINE
| ID: mdl-30813981
ABSTRACT
BACKGROUND:
Surgery for CHD has been slow to develop in parts of the former Soviet Union. The impact of an 8-year surgical assistance programme between an emerging centre and a multi-disciplinary international team that comprised healthcare professionals from developed cardiac programmes is analysed and presented.Material and methodsThe international paediatric assistance programme included five main components - intermittent clinical visits to the site annually, medical education, biomedical engineering support, nurse empowerment, and team-based practice development. Data were analysed from visiting teams and local databases before and since commencement of assistance in 2007 (era A 2000-2007; era B 2008-2015). The following variables were compared between periods annual case volume, operative mortality, case complexity based on Risk Adjustment for Congenital Heart Surgery (RACHS-1), and RACHS-adjusted standardised mortality ratio.RESULTS:
A total of 154 RACHS-classifiable operations were performed during era A, with a mean annual case volume by local surgeons of 19.3 at 95% confidence interval 14.3-24.2, with an operative mortality of 4.6% and a standardised mortality ratio of 2.1. In era B, surgical volume increased to a mean of 103.1 annual cases (95% confidence interval 69.1-137.2, p<0.0001). There was a non-significant (p=0.84) increase in operative mortality (5.7%), but a decrease in standardised mortality ratio (1.2) owing to an increase in case complexity. In era B, the proportion of local surgeon-led surgeries during visits from the international team increased from 0% (0/27) in 2008 to 98% (58/59) in the final year of analysis.CONCLUSIONS:
The model of assistance described in this report led to improved adjusted mortality, increased case volume, complexity, and independent operating skills.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Care Team
/
Thoracic Surgery
/
Program Development
/
Heart Defects, Congenital
/
Cardiac Surgical Procedures
/
Hospitals, Pediatric
/
International Cooperation
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Humans
Country/Region as subject:
Europa
Language:
En
Journal:
Cardiol Young
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
PEDIATRIA
Year:
2019
Document type:
Article
Affiliation country:
Ukraine