Use of diagnostic information submitted to the United Kingdom Central Cardiac Audit Database: development of categorisation and allocation algorithms

Cardiol Young. 2013 Aug;23(4):491-8. doi: 10.1017/S1047951112001369. Epub 2012 Oct 2.


Objective: To categorise records according to primary cardiac diagnosis in the United Kingdom Central Cardiac Audit Database in order to add this information to a risk adjustment model for paediatric cardiac surgery.

Design: Codes from the International Paediatric Congenital Cardiac Code were mapped to recognisable primary cardiac diagnosis groupings, allocated using a hierarchy and less refined diagnosis groups, based on the number of functional ventricles and presence of aortic obstruction.

Setting: A National Clinical Audit Database. Patients Children undergoing cardiac interventions: the proportions for each diagnosis scheme are presented for 13,551 first patient surgical episodes since 2004.

Results: In Scheme 1, the most prevalent diagnoses nationally were ventricular septal defect (13%), patent ductus arteriosus (10.4%), and tetralogy of Fallot (9.5%). In Scheme 2, the prevalence of a biventricular heart without aortic obstruction was 64.2% and with aortic obstruction was 14.1%; the prevalence of a functionally univentricular heart without aortic obstruction was 4.3% and with aortic obstruction was 4.7%; the prevalence of unknown (ambiguous) number of ventricles was 8.4%; and the prevalence of acquired heart disease only was 2.2%. Diagnostic groups added to procedural information: of the 17% of all operations classed as "not a specific procedure", 97.1% had a diagnosis identified in Scheme 1 and 97.2% in Scheme 2.

Conclusions: Diagnostic information adds to surgical procedural data when the complexity of case mix is analysed in a national database. These diagnostic categorisation schemes may be used for future investigation of the frequency of conditions and evaluation of long-term outcome over a series of procedures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Algorithms
  • Cardiac Surgical Procedures / standards*
  • Child
  • Child, Preschool
  • Databases, Factual*
  • Ductus Arteriosus, Patent / classification
  • Ductus Arteriosus, Patent / epidemiology
  • Ductus Arteriosus, Patent / surgery
  • Female
  • Heart Defects, Congenital / classification
  • Heart Defects, Congenital / epidemiology
  • Heart Defects, Congenital / surgery*
  • Heart Septal Defects, Ventricular / classification
  • Heart Septal Defects, Ventricular / epidemiology
  • Heart Septal Defects, Ventricular / surgery
  • Humans
  • Infant
  • Male
  • Outcome Assessment, Health Care / methods
  • Prevalence
  • Quality Assurance, Health Care / methods*
  • Risk Assessment
  • Tetralogy of Fallot / classification
  • Tetralogy of Fallot / epidemiology
  • Tetralogy of Fallot / surgery
  • United Kingdom / epidemiology