Patients Referred to the Paediatric Cardiology Outpatient Services at Red Cross War Memorial Children's Hospital in 2018: A review of demographics, referral patterns, diagnoses and clinical outcomes

Background: Cardiovascular disease (CVD) in children causes considerable morbidity and mortality in Africa and its impact on health systems is an emerging problem. Paediatric cardiology is a highly specialized field based in tertiary centres with worldwide demand exceeding available resources. Upon suspicion of CVD, specialist investigation, early intervention and follow-up are major challenges in low- and middle-income settings. Aim: To investigate and describe patients referred for specialist cardiology services at a tertiary children's hospital in Africa Methods: Red Cross War Memorial Children's Hospital (RCWMCH) is a tertiary paediatric hospital in Cape Town, South Africa. We reviewed patients referred to our outpatient cardiology service, investigating demographics, spectrum of disease, and clinical outcomes. Results: Between 1 January and 31 December 2018, 625 new patients were referred to cardiology outpatient department (COPD) services. Eighty percent (n=501) had structurally normal hearts. The majority of the remainder with confirmed CVD (98%, n=122) had congenital heart defects. Median age of the cohort with CVD was 3.9 months (IQR: 2.6-12.0) with a slight female preponderance (55%). Thirty-four (28%) patients were scheduled for surgery. Ten percent of referred patients had incomplete letters of referral, furthermore we found no feedback plans to these referring practitioners from the COPD doctors. Conclusion: Demands on paediatric cardiology services at RCWMCH are high. Most referred outpatients have structurally normal hearts, straining an already overwhelmed specialist service. However, 28% of patients found to have congenital defects required surgery, highlighting the need to prioritise certain patients. Strengthening communication and feedback channels between cardiologists and generalists will optimise care.

Grantor

Department of Paediatrics and Child Health

Year dc:date.issued

2022

Author dc:creator

• Tlopo, Canicia Puleng

Advisor dc:contributor.advisor

• Zühlke, Liesl

• Paediatric cardiology referrals
• Low- and middle-income paediatric cardiology services

Handle dc:identifier.uri

http://hdl.handle.net/11427/37363

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/37363