Association Between Remote Monitoring and Interstage Morbidity and Death in Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups.


Journal

Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524

Informations de publication

Date de publication:
05 Dec 2023
Historique:
medline: 7 12 2023
pubmed: 28 11 2023
entrez: 28 11 2023
Statut: ppublish

Résumé

Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES. Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the basis of 6 variables relating to SES. Hierarchical logistic regression, adjusted for potential confounding characteristics, was used to determine the association between SES and death or transplant listing during the interstage period. Of 610 infants, 39 (6.4%) died or were listed for transplant. In unadjusted analysis, the rate of reaching the primary outcome between SES tertiles was similar ( In a large multicenter cohort of infants with single-ventricle heart disease enrolled in a digital remote monitoring program during the interstage period, we found no difference in outcomes based on SES. Our study suggests that this novel technology could help mitigate differences in outcomes for this fragile population of patients.

Sections du résumé

BACKGROUND BACKGROUND
Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.
METHODS AND RESULTS RESULTS
Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the basis of 6 variables relating to SES. Hierarchical logistic regression, adjusted for potential confounding characteristics, was used to determine the association between SES and death or transplant listing during the interstage period. Of 610 infants, 39 (6.4%) died or were listed for transplant. In unadjusted analysis, the rate of reaching the primary outcome between SES tertiles was similar (
CONCLUSIONS CONCLUSIONS
In a large multicenter cohort of infants with single-ventricle heart disease enrolled in a digital remote monitoring program during the interstage period, we found no difference in outcomes based on SES. Our study suggests that this novel technology could help mitigate differences in outcomes for this fragile population of patients.

Identifiants

pubmed: 38014668
doi: 10.1161/JAHA.123.031069
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e031069

Auteurs

Bianca Cherestal (B)

Children's Mercy Kansas City Kansas City MO.

Lori A Erickson (LA)

Children's Mercy Kansas City Kansas City MO.

Janelle R Noel-MacDonnell (JR)

Children's Mercy Kansas City Kansas City MO.
University of Missouri-Kansas City Kansas City MO.

Girish Shirali (G)

Children's Mercy Kansas City Kansas City MO.

Hayley S Graue Hancock (HS)

Children's Mercy Kansas City Kansas City MO.

Doaa Aly (D)

UCSF Benioff Children's Hospital San Francisco CA.

Matthew Files (M)

Seattle Children's Hospital Seattle WA.

Sarah Clauss (S)

Children's National Hospital Washington DC.

Natalie Jayaram (N)

Children's Mercy Kansas City Kansas City MO.

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