{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:39:51Z","timestamp":1787319591610,"version":"build-2736575974"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2024,12]]},"abstract":"Abstract<\/jats:title>\n \n Objective:<\/jats:title>\n It is unclear how extracorporeal membrane oxygenation use varies across paediatric cardiac surgical programmes and how it relates to post-operative mortality. We aimed to determine hospital-level variation in post-operative extracorporeal membrane oxygenation use and its association with case-mix adjusted mortality.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Retrospective analysis of 37 hospitals contributing to the Pediatric Cardiac Critical Care Consortium clinical registry from 1 August 2014 to 31 December 2019. Hospitalisations including cardiothoracic surgery and post-operative admission to paediatric cardiac ICUs were included. Two-level multivariable logistic regression with hospital random effect was used to determine case-mix adjusted post-operative extracorporeal membrane oxygenation use rates and in-hospital mortality. Hospitals were grouped into extracorporeal membrane oxygenation use tertiles, and mortality was compared across tertiles.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n There were 43,640 eligible surgical hospitalisations; 1397 (3.2%) included at least one post-operative extracorporeal membrane oxygenation run. Case-mix adjusted extracorporeal membrane oxygenation rates varied more than sevenfold (0.9\u20136.9%) across hospitals, and adjusted mortality varied 10-fold (0\u20135.5%). Extracorporeal membrane oxygenation rates were 2.0%, 3.5%, and 5.2%, respectively, for low, middle, and high extracorporeal membrane oxygenation use tertiles (\n P<\/jats:italic>\n < 0.0001), and mortality rates were 1.9%, 3.0%, and 3.1% (\n p<\/jats:italic>\n < 0.0001), respectively. High extracorporeal membrane oxygenation use hospitals were more likely to initiate extracorporeal membrane oxygenation support intraoperatively (1.6% vs. 0.6% low and 1.1% middle,\n p<\/jats:italic>\n < 0.0001). Extracorporeal membrane oxygenation indications were similar across hospital tertiles. When extracorporeal cardiopulmonary resuscitation was excluded, variation in extracorporeal membrane oxygenation use rates persisted (1.5%, 2.6%, 3.8%,\n p<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n There is hospital variation in adjusted post-operative extracorporeal membrane oxygenation use after paediatric cardiac surgery and a significant association with adjusted post-operative mortality. These findings suggest that post-operative extracorporeal membrane oxygenation use could be a complementary quality metric to mortality to assess performance of cardiac surgical programmes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1047951124026568","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T04:13:32Z","timestamp":1728015212000},"page":"2543-2550","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Hospital variation in post-operative cardiac extracorporeal membrane oxygenation use and relationship to post-operative mortality"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4949-9901","authenticated-orcid":false,"given":"Marissa A.","family":"Brunetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-5604","authenticated-orcid":false,"given":"J. William","family":"Gaynor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mousumi","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuliya A.","family":"Domnina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gaies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"S1047951124026568_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001776"},{"key":"S1047951124026568_ref4","unstructured":"4. Pediatric Cardiac Critical Care Consortium. Data definitions manual. (n.d.) https:\/\/pc4.arbormetrix.com\/Registry\/html\/datacollection.html?menuId=5183."},{"key":"S1047951124026568_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.046"},{"key":"S1047951124026568_ref7","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001571"},{"key":"S1047951124026568_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114001450"},{"key":"S1047951124026568_ref1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001205"},{"key":"S1047951124026568_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.02.035"},{"key":"S1047951124026568_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951121004984"},{"key":"S1047951124026568_ref2","first-page":"658","article-title":"Perioperative mechanical circulatory support in children: an analysis of the society of thoracic surgeons congenital heart surgery database","volume":"147","author":"Mascio","year":"2014","journal-title":"JTCVS."},{"key":"S1047951124026568_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.08.074"},{"key":"S1047951124026568_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.10.069"},{"key":"S1047951124026568_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.03.065"},{"key":"S1047951124026568_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182a5021d"},{"key":"S1047951124026568_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs026"},{"key":"S1047951124026568_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.07.011"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951124026568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:59:15Z","timestamp":1742957955000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951124026568\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,4]]},"references-count":15,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["S1047951124026568"],"URL":"https:\/\/doi.org\/10.1017\/s1047951124026568","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,4]]},"assertion":[{"value":"\u00a9 The Author(s), 2024. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}