Risk Factors for Increased Post-operative Length of Stay in Children with Coarctation of Aorta.
Children
Coarctation of aorta
Length of stay
Outcomes
Journal
Pediatric cardiology
ISSN: 1432-1971
Titre abrégé: Pediatr Cardiol
Pays: United States
ID NLM: 8003849
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
22
01
2021
accepted:
18
05
2021
pubmed:
31
5
2021
medline:
29
9
2021
entrez:
30
5
2021
Statut:
ppublish
Résumé
Coarctation of the aorta is a relatively common congenital heart disease occurring in 0.4-0.6 per 1000 live births with a low mortality rate. This is a retrospective study, with data abstracted from the Pediatric Health Information System database (PHIS). The study sample included pediatric patients less than or equal to 3 months of age discharged from a PHIS participating hospital between January 1, 2004 and December 31, 2018 who underwent surgical repair of isolated COA. The primary outcome for the study was post-operative hospital length of stay (PH-LOS), and the secondary outcome was in-hospital mortality. Patient demographics, comorbidities, procedures, and outcomes were assessed for statistical differences between eras. A total of 5354 patients were included in the study. The study highlights an increasing trend in PH-LOS and NICU hospital length of stay (NICU-LOS) across the investigated eras. Prematurity (before 37 weeks gestation) was an independent risk factor associated with both longer post-operative length of the stay and higher mortality. In addition, congenital anomalies, respiratory and abdominal surgeries have a significant impact on the post-operative hospital stay. In conclusion, this study is the largest published systematic assessment of PH-LOS in patients with isolated COA repair during infancy to date and identifies independent risk factors of increased PH-LOS.
Identifiants
pubmed: 34052859
doi: 10.1007/s00246-021-02641-x
pii: 10.1007/s00246-021-02641-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1567-1574Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Eichhorn JG, Ley S, Kropp F et al (2019) Aortic coarctation a systemic vessel disease-insights from magnetic resonance imaging. Thorac Cardiovasc Surg 67(S04):1–10. https://doi.org/10.1055/s-0039-1697915
doi: 10.1055/s-0039-1697915
Wu Y, Li J, Wu C et al (2020) Diagnosis and surgical repair for coarctation of the aorta with intracardiac defects: a single center experience based on 93 infants. Front Pediatr 8:49. https://doi.org/10.3389/fped.2020.00049
doi: 10.3389/fped.2020.00049
pubmed: 32195209
pmcid: 7062674
Dijkema EJ, Leiner T, Grotenhuis HB (2017) Diagnosis, imaging and clinical management of aortic coarctation. Heart 103(15):1148–1155. https://doi.org/10.1136/heartjnl-2017-311173
doi: 10.1136/heartjnl-2017-311173
pubmed: 28377475
Rodes-Cabau J, Miro J, Dancea A et al (2007) Comparison of surgical and transcatheter treatment for native coarctation of the aorta in patients > or = 1 year old The Quebec Native Coarctation of the Aorta study. Am Heart J 154(1):186–192. https://doi.org/10.1016/j.ahj.2007.03.046
doi: 10.1016/j.ahj.2007.03.046
pubmed: 17584575
Ij R, Liu H, Pigula F et al (2019) Rates of interventions in isolated coarctation repair in neonates versus infants does age matter? Ann Thorac Surg 107(1):180–186. https://doi.org/10.1016/j.athoracsur.2018.07.016
doi: 10.1016/j.athoracsur.2018.07.016
Evers PD, Ranade D, Lewin M, Arya B (2017) Diagnostic approach in fetal coarctation of the aorta: a cost-utility analysis. J Am Soc Echocardiogr 30(6):589–594. https://doi.org/10.1016/j.echo.2017.01.019
doi: 10.1016/j.echo.2017.01.019
pubmed: 28410945
Tulzer A, Mair R, Kreuzer M, Tulzer G (2016) Outcome of aortic arch reconstruction in infants with coarctation: Importance of operative approach. J Thorac Cardiovasc Surg 152(6):1506–1513. https://doi.org/10.1016/j.jtcvs.2016.08.029
doi: 10.1016/j.jtcvs.2016.08.029
pubmed: 27692955
Shim D, Lloyd TR, Moorehead CP, Bove EL, Mosca RS, Beekman RH 3rd (1997) Comparison of hospital charges for balloon angioplasty and surgical repair in children with native coarctation of the aorta. Am J Cardiol 79(8):1143–1146. https://doi.org/10.1016/s0002-9149(97)00068-4
doi: 10.1016/s0002-9149(97)00068-4
pubmed: 9114786
St Louis JD, Harvey BA, Menk JS, O’Brien JE Jr, Kochilas LK (2015) Mortality and operative management for patients undergoing repair of coarctation of the aorta: a retrospective review of the pediatric cardiac care consortium. World J Pediatr Congenit Heart Surg 6(3):431–437. https://doi.org/10.1177/2150135115590458
doi: 10.1177/2150135115590458
pubmed: 26180161
Pagowska-Klimek I, Pychynska-Pokorska M, Krajewski W, Moll JJ (2011) Predictors of long intensive care unit stay following cardiac surgery in children. Eur J Cardiothorac Surg 40(1):179–184. https://doi.org/10.1016/j.ejcts.2010.11.038
doi: 10.1016/j.ejcts.2010.11.038
pubmed: 21227714
Liu M, Druschel CM, Hannan EL (2014) Risk-adjusted prolonged length of stay as an alternative outcome measure for pediatric congenital cardiac surgery. Ann Thorac Surg 97(6):2154–2159. https://doi.org/10.1016/j.athoracsur.2013.11.008
doi: 10.1016/j.athoracsur.2013.11.008
pubmed: 24444872
Shabana, A. Bicuspid aortic valve. e-Journal of Cardiology Practice. Vol. 13, N° 2 - 26 Sep 2014
Pappas A, Shankaran S, Hansen NI et al (2012) outcome of extremely preterm infants (<1000 g) with congenital heart defects from the national institute of child health and human development neonatal research network. Pediatr Cardiol 33(8):1415–1426. https://doi.org/10.1007/s00246-012-0375-8
doi: 10.1007/s00246-012-0375-8
pubmed: 22644414
pmcid: 3687358
Khodaghalian B, Subhedar NV, Chikermane A (2019) Prostaglandin E 2 in a preterm infant with coarctation of the aorta. BMJ Case Rep 12(9):230910. https://doi.org/10.1136/bcr-2019-230910
doi: 10.1136/bcr-2019-230910
Desai J, Aggarwal S, Lipshultz S et al (2017) Surgical interventions in infants born preterm with congenital heart defects: an analysis of the kids’ inpatient database. J Pediatr 191(103–109):e4. https://doi.org/10.1016/j.jpeds.2017.07.015
doi: 10.1016/j.jpeds.2017.07.015
Bacha EA, Almodovar M, Wessel DL et al (2001) surgery for coarctation of the aorta in infants weighing less than 2 kg. Ann Thorac Surg 71(4):1260–1264. https://doi.org/10.1016/s0003-4975(00)02664-3
doi: 10.1016/s0003-4975(00)02664-3
pubmed: 11308171
Burch PT, Cowley CG, Holubkov R et al (2009) Coarctation repair in neonates and young infants:is small size or low weight still a risk factor? J Thorac Cardiovasc Surg 138(3):547–552. https://doi.org/10.1016/j.jtcvs.2009.04.046
doi: 10.1016/j.jtcvs.2009.04.046
pubmed: 19698833
Sudarshan CD, Cochrane AD, Jun ZH, Soto R, Brizard CP (2006) Repair of coarctation of the aorta in infants weighing less than 2 kilograms. Ann Thorac Surg 82(1):158–163. https://doi.org/10.1016/j.athoracsur.2006.03.007
doi: 10.1016/j.athoracsur.2006.03.007
pubmed: 16798207
Bansal N, Balakrishnan PL, Aggarwal S (2019) Prostaglandin infusion in neonate with severe coarctation of the aorta with closed ductus arteriosus-a case report and review of the literature. World J Pediatr Congenit Heart Surg. https://doi.org/10.1177/2150135118799635
doi: 10.1177/2150135118799635
pubmed: 31117879
Costello JM, McQuillen PS, Claud EC, Steinhorn RH (2011) Prematurity and congenital heart disease. World J Pediatr Congenit Heart Surg 2(3):457–467. https://doi.org/10.1177/2150135111408445
doi: 10.1177/2150135111408445
pubmed: 23803997
Dharmapuram AK, Ramadoss N, Verma S, Vejendla G, Ivatury RM (2018) Early outcomes of modification of end to side repair of coarctation of aorta with arch hypoplasia in neonates and infants. Ann Pediatr Card 11:267–274. https://doi.org/10.4103/apc.APC_5_18
doi: 10.4103/apc.APC_5_18
Said SM et al (2014) Ascending-to-descending aortic bypass: a simple solution to a complex problem. Ann Thorac Surg 97(6):2041–2047. https://doi.org/10.1016/j.athoracsur.2014.02.030
doi: 10.1016/j.athoracsur.2014.02.030
pubmed: 24725830
Benneyworth BD, Shao JM, Cristea AI et al (2016) Tracheostomy following surgery for congenital heart disease: a 14-year institutional experience. World J Pediatr Congenit Heart Surg 7(3):360–366. https://doi.org/10.1177/2150135116644432
doi: 10.1177/2150135116644432
pubmed: 27142405
Prodhan P, Agarwal A, ElHassan NO et al (2017) Tracheostomy among infants with hypoplastic left heart syndrome undergoing cardiac operations: a multicenter analysis. Ann Thorac Surg 103(4):1308–1314. https://doi.org/10.1016/j.athoracsur.2016.09.016
doi: 10.1016/j.athoracsur.2016.09.016
pubmed: 27865477
Mastropietro CW, Benneyworth BD, Turrentine M et al (2016) Tracheostomy after operations for congenital heart disease: an analysis of the society of thoracic surgeons congenital heart surgery database. Ann Thorac Surg 101(6):2285–2292. https://doi.org/10.1016/j.athoracsur.2016.01.046
doi: 10.1016/j.athoracsur.2016.01.046
pubmed: 27083243
Maxwell BG, McMillan KN (2014) Tracheostomy in children with congenital heart disease: a national analysis of the Kids’ Inpatient Database. PeerJ 2:e568. https://doi.org/10.7717/peerj.568
doi: 10.7717/peerj.568
pubmed: 25250217
pmcid: 4168842
Piggott KD, Babb J, Yong S et al (2018) Risk factors for gastrostomy tube placement in single ventricle patients following the norwood procedure. Semin Thorac Cardiovasc Surg Winter 30(4):443–447. https://doi.org/10.1053/j.semtcvs.2018.02.012
doi: 10.1053/j.semtcvs.2018.02.012
McKean EB, Kasparian NA, Batra S, Sholler GF, Winlaw DS, Dalby-Payne J (2017) Feeding difficulties in neonates following cardiac surgery: determinants of prolonged feeding-tube use. Cardiol Young 27(6):1203–1211. https://doi.org/10.1017/S1047951116002845
doi: 10.1017/S1047951116002845
pubmed: 28112059
Rossi AF, Fishberger S, Hannan RL et al (2009) Frequency and indications for tracheostomy and gastrostomy after congenital heart surgery. Pediatr Cardiol 30(3):225–231. https://doi.org/10.1007/s00246-008-9324-y
doi: 10.1007/s00246-008-9324-y
pubmed: 19011726
Kemper AR, Mahle WT, Martin GR et al (2011) Strategies for implementing screening for critical congenital heart disease. Pediatrics 128(5):e1259–e1267
doi: 10.1542/peds.2011-1317