{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:21:53Z","timestamp":1787505713233,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2015,1,20]]},"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore changes over time in the 30-day mortality rate for paediatric cardiac surgery and to understand the role of attendant changes in the case mix.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods, setting and participants<\/jats:title>\n                    <jats:p>\n                      Included were: all mandatory submissions to the National Institute of Cardiovascular Outcomes Research (NICOR) relating to UK cardiac surgery in patients aged &lt;16\u2005years. The \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test for trend was used to retrospectively analyse the proportion of surgical episodes ending in 30-day mortality and with various case mix indicators, in 10 consecutive time periods, from 2000 to 2010. Comparisons were made between two 5-year eras of: 30-day mortality, period prevalence and mean age for 30 groups of specific operations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>30-day mortality for an episode of surgical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our analysis includes 36\u2005641 surgical episodes with an increase from 2283 episodes in 2000 to 3939 in 2009 (p&lt;0.01). The raw national 30-day mortality rate fell over the period of review from 4.3% (95% CI 3.5% to 5.1%) in 2000 to 2.6% (95% CI 2.2% to 3.0%) in 2009\/2010 (p&lt;0.01). The case mix became more complex in terms of the percentage of patients &lt;2.5\u2005kg (p=0.05), with functionally univentricular hearts (p&lt;0.01) and higher risk diagnoses (p&lt;0.01). In the later time era, there was significant improvement in 30-day mortality for arterial switch with ventricular septal defect (VSD) repair, patent ductus arteriosus ligation, Fontan-type operation, tetralogy of Fallot and VSD repair, and the mean age of patients fell for a range of operations performed in infancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The raw 30-day mortality rate for paediatric cardiac surgery fell over a decade despite a rise in the national case mix complexity, and compares well with international benchmarks. Definitive repair is now more likely at a younger age for selected infants with congenital heart defects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2014-000157","type":"journal-article","created":{"date-parts":[[2015,4,3]],"date-time":"2015-04-03T10:39:06Z","timestamp":1428057546000},"page":"e000157","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":84,"title":["Trends in 30-day mortality rate and case mix for paediatric cardiac surgery in the UK between 2000 and 2010"],"prefix":"10.1136","volume":"2","author":[{"given":"Katherine L","family":"Brown","sequence":"first","affiliation":[{"name":"Cardiac Unit, Great Ormond Street Hospital for Children, London, UK"},{"name":"Institute for Cardiovascular Science, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya","family":"Crowe","sequence":"additional","affiliation":[{"name":"Clinical Operational Research Unit, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"McLean","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, The Royal Hospital for Sick Children, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cunningham","sequence":"additional","affiliation":[{"name":"National Institute for Cardiac Outcomes Research (NICOR), University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Barron","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Birmingham Children's Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Tsang","sequence":"additional","affiliation":[{"name":"Cardiac Unit, Great Ormond Street Hospital for Children, London, UK"},{"name":"Institute for Cardiovascular Science, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Pagel","sequence":"additional","affiliation":[{"name":"Clinical Operational Research Unit, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Utley","sequence":"additional","affiliation":[{"name":"Clinical Operational Research Unit, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,4,2]]},"reference":[{"key":"2025081710191059000_2.1.e000157.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05404-6"},{"key":"2025081710191059000_2.1.e000157.2","unstructured":"NHS. 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London: The Information Centre, 2011. https:\/\/nicor4.nicor.org.uk\/CHD\/an_paeds.nsf\/WBenchmarksYears?openview&RestrictToCategory=2013&start=1&count=500"},{"key":"2025081710191059000_2.1.e000157.4","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951108002795"},{"key":"2025081710191059000_2.1.e000157.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-009-9496-0"},{"key":"2025081710191059000_2.1.e000157.6","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.119064"},{"key":"2025081710191059000_2.1.e000157.7","doi-asserted-by":"publisher","DOI":"10.1053\/j.pcsu.2004.02.011"},{"key":"2025081710191059000_2.1.e000157.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.06.023"},{"key":"2025081710191059000_2.1.e000157.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.03.071"},{"key":"2025081710191059000_2.1.e000157.10","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951112001369"},{"key":"2025081710191059000_2.1.e000157.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.019"},{"key":"2025081710191059000_2.1.e000157.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.06.008"},{"key":"2025081710191059000_2.1.e000157.13","doi-asserted-by":"publisher","DOI":"10.1177\/2150135112439586"},{"key":"2025081710191059000_2.1.e000157.14","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt307"},{"key":"2025081710191059000_2.1.e000157.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.027"},{"key":"2025081710191059000_2.1.e000157.16","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304848"},{"key":"2025081710191059000_2.1.e000157.17","unstructured":"Townsend N , Bhatnagar P , Wickramasinghe K , et al . Children and young people statistics. London, UK: Foundation BH, 2013."},{"key":"2025081710191059000_2.1.e000157.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.10.032"},{"key":"2025081710191059000_2.1.e000157.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.01.105"},{"key":"2025081710191059000_2.1.e000157.20","unstructured":"EACTS. EACTS congenital database gold standards. In: Surgery EAfC, ed. Congenital database gold standard reports. Warsaw Poland: Children's Memorial Health Institute, 2013.http:\/\/www.eactscongenitaldb.org\/index.php?LANG=en&level=2&struct=14_1"},{"key":"2025081710191059000_2.1.e000157.21","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951108002862"},{"key":"2025081710191059000_2.1.e000157.22","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/15.1.7"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2014-000157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:19:18Z","timestamp":1755451158000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2014-000157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,4,2]]},"published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1136\/openhrt-2014-000157"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2014-000157","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2]]}}}