Care for children undergoing surgery: we are not there yet.

摘要

Are we there yet? is the title of the latest National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report released on Oct 27, which reviews organisational and clinical aspects of children's surgery in the UK.The review is based on 378 children aged 17 years and younger who died within 30 days of a surgical procedure between 2008 and 2010, as well as an organisational survey of 290 hospitals where the operations were done. 71% of patients were judged to have received good care, but there was room for improvement in the care of 26% of patients. End-of-life care planning was absent in at least 50% of 235 children in whom it would have been appropriate. There were difficulties in diagnosis and decision making in surgical intervention for necrotising enterocolitis, which resulted in a third of all 378 deaths.