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Original Article

Comparing the post-operative complications in pediatric patients undergoing cardiovascular procedures at a single institute

Usman Younis Panni, Asra Wahid, Mohammad Qasim Mehdi, Arsal Tharwani, Muhammad Muneer Amanullah.

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Background: Post-operative complications (POC) contribute a significant burden on healthcare providers and patients. Quantification of POC using standard methods is important to make comparisons between different institutions and reduce POC. The aim of this study is to compare the currently used chart review system with a standardized system of recording complications i.e. NSQIP-P in pediatric patients who underwent corrective cardiac surgery at a tertiary care hospital in Pakistan.
Methodology: A total of 134 patients were included in this study. Data was retrospectively collected from medical records of the patients. Multiple variables were recorded including demographic factors, comorbidities, intraoperative and post-operative recovery variables. We then used NSQIP-P definitions to define post-operative complications. Data was analyzed using SPSS 20.
Results: Significant differences were found between the two methods on comparative analysis. AKI (p-value = 0.035), pneumonia (p-value = 0.0013) and sepsis (p-value = 0.004) were under-reported while CVA (p-value = 0.004) was over-reported on chart review when compared to NSQIP-P definitions.
Conclusion: Our results highlight the need for having a standard system of defining POC, which will allow the comparison of POC across different hospitals. For a healthcare system with limited resources like Pakistan, it is even more important to identify the areas that need improvement so post-operative outcomes can be improved.

Key words: Post-operative complications, morbidity, pediatric cardiovascular surgery, congenital heart disease, surgical outcome, quality improvement.

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