Our Summary
This research paper analyzes data from children who had heart surgery between 2013 and 2019, focusing specifically on the rates of ‘failure to rescue’ (FTR), a term used to describe situations where a patient dies after developing complications. The researchers found that some hospitals had higher rates of FTR than others, and that these rates were strongly associated with overall death rates. However, the rates of FTR were not significantly linked with the rates of complications. This suggests that the difference in death rates between hospitals may be more due to how well they deal with complications, rather than how many complications occur. Therefore, FTR could be a useful way to measure the quality of heart surgeries in children, though more research is needed to clarify its definition and how to adjust for risk.
FAQs
- What is the term ‘failure to rescue’ (FTR) as used in the context of this research?
- What correlation was found between FTR rates and overall death rates in pediatric cardiac surgery?
- How could FTR potentially be used to measure the quality of heart surgeries in children?
Doctor’s Tip
A doctor might advise a patient about pediatric cardiac surgery to choose a hospital with low rates of ‘failure to rescue’ (FTR) as this could be a good indicator of the quality of care provided. It is important to ask the hospital about their FTR rates and how they handle complications during and after surgery. Additionally, it is crucial to follow all post-operative care instructions carefully to ensure the best possible outcome for the child undergoing cardiac surgery.
Suitable For
Patients who are typically recommended pediatric cardiac surgery include those with congenital heart defects, acquired heart conditions, and heart rhythm disorders. These patients may range in age from newborns to young adults. Pediatric cardiac surgery is often recommended for patients who have complex heart conditions that cannot be managed with medication or other non-invasive treatments. Additionally, patients who are experiencing symptoms such as difficulty breathing, poor growth, or fatigue due to their heart condition may also be recommended for surgery.
Common conditions that may indicate the need for pediatric cardiac surgery include:
Congenital heart defects: These are heart abnormalities that are present at birth and may affect the structure and function of the heart. Examples include atrial septal defects, ventricular septal defects, tetralogy of Fallot, and transposition of the great arteries.
Acquired heart conditions: These are heart conditions that develop after birth and may be caused by infections, autoimmune disorders, or other factors. Examples include rheumatic heart disease, Kawasaki disease, and myocarditis.
Heart rhythm disorders: These are abnormalities in the electrical system of the heart that can cause irregular heartbeats or other issues. Examples include atrial fibrillation, ventricular tachycardia, and Wolff-Parkinson-White syndrome.
Overall, pediatric cardiac surgery is recommended for patients who are at risk of serious complications or death due to their heart condition. The decision to undergo surgery is typically made after a thorough evaluation by a multidisciplinary team of pediatric cardiologists, cardiac surgeons, anesthesiologists, and other specialists. The goal of pediatric cardiac surgery is to improve the patient’s quality of life, reduce symptoms, and prevent long-term complications.
Timeline
Before pediatric cardiac surgery:
- Patient is diagnosed with a cardiac condition that requires surgery
- Patient undergoes preoperative testing and evaluation to assess their overall health and determine the best course of treatment
- Patient and family meet with the surgical team to discuss the procedure, potential risks, and expected outcomes
- Patient may undergo additional preoperative interventions or treatments to prepare for surgery
- Patient is admitted to the hospital on the day of surgery and undergoes the procedure under general anesthesia
After pediatric cardiac surgery:
- Patient is closely monitored in the intensive care unit (ICU) immediately after surgery
- Patient may require mechanical ventilation and other supportive measures to ensure a successful recovery
- Patient is gradually weaned off of these supports as they begin to recover and stabilize
- Patient may experience complications postoperatively, such as infection, bleeding, or arrhythmias, which require prompt recognition and treatment
- Patient is transferred to a regular hospital floor once they are stable enough to leave the ICU
- Patient undergoes physical therapy and other rehabilitation measures to help them regain strength and function
- Patient and family receive education on postoperative care, including medications, follow-up appointments, and signs of potential complications
- Patient is discharged from the hospital and continues to follow up with their medical team for long-term management of their cardiac condition.
What to Ask Your Doctor
- What is the success rate of pediatric cardiac surgeries at this hospital?
- How experienced is the surgical team in performing pediatric cardiac surgeries?
- What are the potential risks and complications associated with the surgery?
- How will the surgery be performed and what is the expected recovery time?
- How will pain management be addressed post-surgery?
- Will there be a need for follow-up appointments or additional treatments after the surgery?
- Are there any alternative treatment options available?
- What is the hospital’s protocol for managing complications during or after surgery?
- How does the hospital handle emergency situations and what is the rate of ‘failure to rescue’ for pediatric cardiac surgeries?
- Are there any support services or resources available for families during and after the surgery?
Reference
Authors: Verma A, Williamson CG, Bakhtiyar SS, Hadaya J, Hekking T, Kronen E, Si MS, Benharash P. Journal: Ann Thorac Surg. 2024 Mar;117(3):552-559. doi: 10.1016/j.athoracsur.2023.05.001. Epub 2023 May 12. PMID: 37182822