Your browser doesn't support javascript.
loading
Impact of Medical Interventions and Comorbidities on Norwood Admission for Patients with Hypoplastic Left Heart Syndrome.
Loomba, Rohit S; Rausa, Jacqueline; Farias, Juan S; Villarreal, Enrique G; Acosta, Sebastian; Savorgnan, Fabio; Flores, Saul.
Afiliação
  • Loomba RS; Division of Cardiology, Advocate Children's Hospital, Oak Lawn, IL, USA.
  • Rausa J; Department of Pediatrics, Chicago Medical School/Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
  • Farias JS; Division of Cardiology, Advocate Children's Hospital, Oak Lawn, IL, USA.
  • Villarreal EG; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. jsfariast@gmail.com.
  • Acosta S; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico.
  • Savorgnan F; Section of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, TX, USA.
  • Flores S; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Pediatr Cardiol ; 43(2): 267-278, 2022 Feb.
Article em En | MEDLINE | ID: mdl-35034159
ABSTRACT
The purpose of these analyses was to determine how specific comorbidities and medical interventions impact risk of inpatient mortality in those with hypoplastic left heart syndrome undergoing Norwood procedure. The secondary aims were to determine the impact of these on billed charges, postoperative length of stay, and risk of cardiac arrest. Admissions from 2004 to 2015 in the Pediatric Health Information System database with hypoplastic left heart syndrome and Norwood procedure were identified. Admission characteristics, patient interventions, and the presence of comorbidities were captured. A total of 5,138 admissions were identified meeting inclusion criteria. Of these 829 (16.1%) experienced inpatient mortality, and 352 (6.7%) experienced cardiac arrest. The frequency of inpatient mortality did not significantly change over the course of the study era. The frequency of cardiac arrest significantly decreased from 7.4% in 2004 to 4.3% in 2015 (p = 0.04). The frequency of pharmacologic therapies, particularly vasoactive use, decreased as the study period progressed. Regression analyses demonstrated a significant association between cardiac arrest and inpatient mortality with arrhythmias, acute kidney injury, and pulmonary hypertension. Similarly, regression analyses demonstrated a significant association between increase in billed charges and length of stay with year of surgery, presence of heart failure, syndromes, and acute kidney injury. For patients with hypoplastic left heart syndrome undergoing the Norwood procedure, the frequency of pharmacologic therapies and cardiac arrest has decreased over time. There are significant associations between acute kidney injury, arrythmias, and pulmonary hypertension with cardiac arrest and mortality.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Coração Esquerdo Hipoplásico / Injúria Renal Aguda / Procedimentos de Norwood Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: Pediatr Cardiol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Coração Esquerdo Hipoplásico / Injúria Renal Aguda / Procedimentos de Norwood Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: Pediatr Cardiol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos