(Press-News.org) Deaths within 30 days of children's heart surgery have almost halved in the UK over the past decade, despite a rise in the number and complexity of cases during that period, reveals an analysis of national data, published in the online journal Open Heart.
The findings prompt the researchers to suggest that it is now time to shift the focus to longer term survival and other issues that matter greatly to patients and their families, such as measures of ill health and impact on functional capacity.
Children's heart surgery in the UK has come under intense public scrutiny since the 1990s, when much higher than expected death rates were found at Bristol Royal Infirmary, while recent plans to reconfigure children's heart surgery services in England have shone a further spotlight on the figures.
Mandatory reporting of children's heart surgery outcomes was introduced in 1997, and all specialist centres have submitted data to the UK Congenital Heart Audit since 2000, with figures for each individual centre published since 2004.
In a bid to assess trends over time, the researchers analysed data submitted to the National Institute of Cardiovascular Outcomes Research (NICOR) for all children under 16 between 2000 and 2010 inclusive.
The analysis included a total of 36,641 episodes of surgery, corresponding to 30,041 individual patients, 5142 of whom underwent two or more surgical episodes. In around one in 20 (4.4%) of these episodes, the child had further surgery within 30 days.
The annual number of episodes rose between 2283 in 2000 to 3939 in 2009 while the 30 day death rate fell consistently from 4.3% of cases to 2.6%.
This was despite an increase in the number and complexity of cases coming through for surgery.
These figures, "suggest that rather than turning away higher risk patients during an era when outcomes have been monitored more closely, conversely, a greater proportion of more complex patients were taken on in later years," write the researchers.
Overall death rates are low and falling, and compare well with similar data from other international databases, they say.
"The very low mortality rates at 30 days must shift our focus now towards measures of morbidity, longer term survival outcomes (such as survival to 90 days or 1 year) and functional outcomes, which, although of great importance to patients and their families, are less well delineated, and furthermore may provide evidence on the comparative long term benefits of different surgical strategies and models of care," they conclude.
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Passive exposure to bleach in the home is linked to higher rates of childhood respiratory and other infections, suggests research published online in Occupational & Environmental Medicine.
Although modest, the results are of public health concern in light of the widespread use of bleach in the home, say the researchers, who call for further more detailed studies in this area.
The researchers looked at the potential impact of exposure to bleach in the home among more than 9000 children between the ages of 6 and 12 attending 19 schools in Utrecht, The Netherlands; 17 ...
Highlights
High parathyroid hormone levels and subsequent bone loss are major risk factors for worsening of coronary artery calcification in patients on dialysis.
Washington, DC (April 2, 2015) -- Bone loss may be a sign of poor heart health in patients on dialysis, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Monitoring bone loss in dialysis patients may therefore provide an early alert to physicians concerning cardiovascular problems.
Most patients with chronic kidney disease who are on dialysis ...
Using archival data from the Japan-led Suzaku X-ray satellite, astronomers have determined the pre-explosion mass of a white dwarf star that blew up thousands of years ago. The measurement strongly suggests the explosion involved only a single white dwarf, ruling out a well-established alternative scenario involving a pair of merging white dwarfs.
"Mounting evidence indicates both of these mechanisms produce what we call type Ia supernovae," said lead researcher Hiroya Yamaguchi, an astrophysicist at NASA's Goddard Space Flight Center in Greenbelt, Maryland. "To understand ...
Boston, MA - Harvard T.H. Chan School of Public Health researchers are calling upon police in all states to improve their reporting of crashes involving vehicles and bicycles, according to a new study being published Thursday, April 2, 2015. Currently, details on crashes are handwritten by police on paper and there are few bicycle-relevant codes. The researchers are calling for police to use electronic tablets that would include more options to gather bicycle-specific data, such as drawings of the scene and additional codes that could indicate, for example, if the bicyclist ...
LOS ANGELES -- Using herpesvirus, molecular immunologists from the University of Southern California (USC) Norris Comprehensive Cancer Center have discovered a cellular process that activates a critical immune defense against pathogens, which could have implications for developing drugs to bolster one's immunity to infection. Some herpesvirus infections lead to cancer.
Led by Pinghui Feng, Ph.D., associate professor of molecular microbiology and immunology at the Keck School of Medicine of USC, the team found that herpesvirus proteins activate retinoic acid-induced gene ...
DURHAM, N.C. -- The saying "what doesn't kill you makes you stronger" may not hold up to scientific scrutiny. Baboons born in times of famine are more vulnerable to food shortages later in life, finds a new study.
The findings are important because they help explain why people who are malnourished in early childhood often experience poor health as adults.
After the plains of southern Kenya experienced a severe drought in 2009 that took a terrible toll on wildlife, researchers at Duke and Princeton Universities looked at how 50 wild baboons coped with the drought, and ...
CORVALLIS, Ore. - Engineers have combined innovative optical technology with nanocomposite thin-films to create a new type of sensor that is inexpensive, fast, highly sensitive and able to detect and analyze a wide range of gases.
The technology might find applications in everything from environmental monitoring to airport security or testing blood alcohol levels. The sensor is particularly suited to detecting carbon dioxide, and may be useful in industrial applications or systems designed to store carbon dioxide underground, as one approach to greenhouse gas reduction.
Oregon ...
Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant superbug, can cause life-threatening skin, bloodstream and surgical site infections or pneumonia. Researchers at the University of California, San Diego School of Medicine now report that cigarette smoke may make matters worse. The study, published March 30 by Infection and Immunity, shows that MRSA bacteria exposed to cigarette smoke become even more resistant to killing by the immune system.
"We already know that smoking cigarettes harms human respiratory and immune cells, and now we've shown ...
(SACRAMENTO, Calif.) -- The micro RNA miR-22 has long been known for its ability to suppress cancer. However, questions remain about how it achieves this feat. For example, which molecules are regulating miR-22, and which are miR22 targets?
Researchers at UC Davis have unraveled some of these relationships, identifying several interactions that directly impact liver and colon cancer. The work provides new insights into how miR-22 operates and could potentially lead to new cancer therapies. The study was published in the Journal of Biological Chemistry.
"There are quite ...
WASHINGTON, April 2, 2015 -- It's supposed to help keep our bodies healthy in stressful situations. But the constant stress of our everyday lives means we're getting overexposed to cortisol. Raychelle Burks, Ph.D., explains why too much cortisol is bad for you in the latest episode of the Reactions series Get To Know A Molecule. Check it out here: https://youtu.be/fPnDaRYXHs4.
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