1. Management errors in adults with congenital heart disease: prevalence, sources, and consequences
- Author
-
Peter Robinson, Jens G. Kilian, Richard B. Chard, David S. Celermajer, Irina Kotchetkova, Lynne Pressley, David Tanous, Subha Nasir Ahmad, Gry Eveborn, Rachael Cordina, Julian Ayer, and John E. Deanfield
- Subjects
Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Heart disease ,Adolescent ,Population ,MEDLINE ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Prevalence ,Medicine ,Humans ,030212 general & internal medicine ,Major complication ,Registries ,Young adult ,Disease management (health) ,education ,Aged ,Retrospective Studies ,education.field_of_study ,Medical Errors ,business.industry ,Disease Management ,Retrospective cohort study ,Guideline ,Middle Aged ,medicine.disease ,Emergency medicine ,Practice Guidelines as Topic ,Patient Compliance ,Female ,New South Wales ,Cardiology and Cardiovascular Medicine ,business ,Delivery of Health Care ,Follow-Up Studies - Abstract
Aims Improved survival has resulted in increasing numbers and complexity of adults with congenital heart disease (ACHD). International guidelines recommend specialized care but many patients are still not managed at dedicated ACHD centres. This study analysed referral sources and appropriateness of management for patients referred to our tertiary ACHD Centre over the past 3 years. Methods and results We compared differences in care between patients referred from paediatric/ACHD-trained vs. general adult cardiologists, according to Adherence (A) or Non-Adherence (NA) with published guidelines. Non-Adherent cases were graded according to the severity of adverse outcome or risk of adverse outcome. Of 309 consecutively referred patients (28 ± 14 years, 51% male), 134 (43%) were from general cardiologists (19% highly complex CHD) and 115 (37%) were from paediatric cardiology or ACHD specialists (33% highly complex CHD). Sixty referrals (20%) were from other medical teams and of those, 31 had been lost to follow-up. Guideline deviations were more common in referrals from general compared to CHD-trained cardiologists (P
- Published
- 2017