Annex A > Chapter 19 - Statistics Relating to the Clinical Performance of Paediatric Cardiac Surgical Services in Bristol Compared with Other Specialist Centres during the Period 1984 to 1995 > Section four: the evidence of the Inquiry's Experts relating to post-operative morbidity
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Section four: the evidence of the Inquiry's Experts relating to post-operative morbidity
Terminology
107 Dr Kate Bull described, in a paper prepared for the Inquiry, the meaning of the term `morbidity' in the context of paediatric cardiac surgery:
`Doctors use the term "morbidity" to contrast with a complication-free recovery to a normal state. Cardiac surgery has cardiac outcomes with effects on longevity and quality of life that vary from trivial to severe; very few heart operations are "corrective". The long-term non-cardiac complications of open heart surgery in children include a variety of problems under the heading of "brain damage" or "learning difficulties", problems with the mechanics of breathing (diaphragm palsy, tracheal and chest wall problems) and the psychological consequences of the disease and its treatment on child, siblings and parents. There are also many short-term complications, which may increase length of stay in intensive care or in hospital including infection and respiratory problems; often these are not associated with long-term sequelae. As in natural language, the medical use of a term does not necessarily mean that it has been unambiguously defined.' [160]
108 The definition of `post-operative morbidity' adopted by the Inquiry was set out by Leading Counsel to the Inquiry:
`We take the term "post-operative morbidity" to mean problems with a child's health which were not apparently present before the surgery and which manifest themselves as functional impairments or disabilities, and which would not have been present, or present to such an extent, in the absence of surgery.' [161]
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Footnotes
[160] INQ 0049 0002; `Key issues in retrospective evaluation of morbidity outcomes following paediatric cardiac surgery', November 2000, Dr Bull