Hospital Volume of Surgery for Congenital Heart Problems may Impact Patient Outcomes
There are a host of birth defects that require surgical correction after a baby is born, the most common of which are congenital heart problems. In fact, 40,000 babies in the United States are born with congenital heart defects every year, amounting to 1 out of every 100 births. A recent analysis conducted by U.S. News showed an association between the number of congenital heart surgeries performed in a hospital and the survival rates for children who need these highly complex procedures.
A congenital heart defect can refer to any issue affecting the structure of the heart. Depending on the specific type of heart defect, the heart’s walls, valves, arteries, or veins may be affected. A congenital heart defect is present when a baby is born, resulting from abnormal growth or development of the heart’s structure in utero. When these defects exist, they can disrupt or impede the necessary blood flow to and from an infant’s heart. Often, a baby with a congenital heart defect will require one or more surgeries to repair the underlying issue.
Congenital Heart Surgery in U.S. Hospitals
In the aforementioned study, U.S. News evaluated the two most complex categories of congenital heart surgery between January 2012 and December 2015 at 61 hospitals across the United States. The intention of the investigation was to ascertain the relationship between hospital volume of these surgeries and patient outcomes.
Among 4,000 heart procedures over 4 years, data showed that 26 percent of deaths may have been preventable had the surgeries taken place at hospitals where the highest number of these procedures were performed. According to the findings, 104 of the 395 deaths (more than 1 out of 4) after surgery may not have occurred if the surgeries took place in high-volume medical centers.
To quantify what constitutes each level of volume, U.S. News employed existing thresholds established by the Society of Thoracic Surgeons. Specifically, low-volume congenital heart surgery programs handled less than 100 cases per year, medium-volume programs handled between 100 and 249 congenital heart surgeries, and high-volume centers handled 250 or more patients with congenital heart defects requiring surgical intervention annually.
It is important to note that the study relied on information provided voluntarily to the public by hospitals. There may be many more deaths in hospitals that do not publicly release their data, according to Matt Austin, an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, and a faculty member at Hopkins’ Armstrong Institute for Patient Safety and Quality.
Does Higher Hospital Volume Mean Better Outcomes?
This analysis confirms previous studies showing that patient outcomes are often better for more complex surgeries when they are performed at higher-volume hospitals. The logic follows that a pediatric surgical team with more experience performing a complex procedure would be better equipped to deliver favorable outcomes when performing a complicated congenital heart problem surgery.
The appropriate surgical procedure is determined by the specific congenital heart problem in a given case. Congenital heart procedures are vast and varied, requiring extensive training that may take years to develop. One study estimates there are 207 distinct surgical interventions that may be used to correct congenital heart problems. In other words, pediatric heart surgeons are tasked with acquiring and implementing a massive skill set as it relates to congenital defects affecting the heart.
As surgeons perform more and more of these operations, they likely enhance their abilities to anticipate potential problems and react appropriately when issues arise. They can also cut-down on the duration of time necessary to complete the procedure and thus, the amount of time the patient relies on bypass.
Congenital Heart Defects and Medical Malpractice
Although higher-volume hospitals may deliver better outcomes, every patient deserves the best chance at life. Moreover, if hospitals refuse to provide information about the frequency of complicated procedures in their facilities, patients are unable to make a truly informed decision about where they, or their child, will receive such a high-risk surgery. This reality is entirely unacceptable in the information age.
At Fronzuto Law Group, our attorneys fight passionately on behalf of children who are victims of medical negligence in New Jersey. Our pediatric malpractice team has experience with some of the most rare congenital disorders and our firm’s founder Ernest Fronzuto consults on these cases nationwide. If your child suffered harm during or after treatment for a congenital heart problem or other birth defect, contact us at (973)-435-4551 for a free consultation. We are happy to answer your questions and discuss your potential legal options.
For additional information related to this study, access the following article: Safety in Numbers, U.S. News