National congenital heart disease audit reveals 30-day surgery survival rates

Published: 08 Sep 2015

Data published today by the National Congenital Heart Disease Audit (NCHDA) shows that 22,719 congenital heart operations and transcatheter interventional procedures were performed across 34 centres, including all 14 specialist paediatric units, between 2011 and 2014 in the UK and Republic of Ireland. No hospital had excess mortality for paediatric surgery within the reporting period as assessed by using the PRAiS risk adjustment model.

Analysis of all hospitals showed an upward trend in survival in the most recent 18 months. The overall survival for all congenital heart disease procedures is extremely high and continues to compare very well with data from international databases in Europe and North America.

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For the 56 Specific Procedures used as a basis of inter?unit comparison, there was only one alert?level outlier for paediatric cardiac surgery for a single centre and none for paediatric intervention, adult (ACHD) cardiac surgery and adult (ACHD) intervention.

Antenatal diagnosis rates (analysed over the 5 year period 2008?2013) continue to rise but there is significant regional variation with detection rates in North Wales being the highest.

The NCHDA is managed by the National Institute for Cardiovascular Outcomes Research (NICOR) and is the largest and most comprehensive national audit of its kind in the world and is now in its 15th year. The audit collects data from all centres undertaking congenital cardiac surgery and interventional procedures in the UK. NCHDA is commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit Programme and clinically led by the British Congenital Cardiac Association and The Society for Cardiothoracic Surgery in Great Britain and Ireland. The analyses are based on data submitted by all 14 paediatric centres and 20 centres who only undertake procedures in adults with congenital heart disease. This covers all NHS and private paediatric and congenital heart disease procedures undertaken in these units between April 1st 2011 and 31st March 2014. Data has undergone a rigorous validation process comprising of site visits by a clinical data auditor and a volunteer clinician and has been verified by each local hospital as being accurate.

The audit uses two control limits: an alert limit (99.5%; red line) and a warning limit (98%; green line). If a unit is above both limits then their performance is not statistically different from the national average. All of the hospitals were above the alert limit of 99.5% for aggregate analysis of all procedures, as well as 30 day survival rates in each of the 56 specific procedures during this period.