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Cardiol Young ; 29(3): 369-374, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30698131

RESUMO

OBJECTIVE: This study sets out to determine the influence of age at the time of surgery as a risk factor for post-operative length of stay after bidirectional cavopulmonary anastomosis. METHODS: All patients undergoing a Glenn procedure between January 2010 and July 2015 were included in this retrospective cohort study. Demographic data were examined. Standard descriptive statistics was used. A univariable analysis was conducted using the appropriate test based on data distribution. A propensity score for balancing the group difference was included in the multi-variable analysis, which was then completed using predictors from the univariable analysis that achieved significance of p<0.1. RESULTS: Over the study period, 50 patients met the inclusion criteria. Patients were separated into two cohorts of ⩾4 months (28 patients) and <4 months (22 patients). Other than height and weight, the two cohorts were indistinguishable in their pre-operative saturation, medications, catheterisation haemodynamics, atrioventricular valve regurgitation, and ventricular function. After adjusting group differences, younger age was associated with longer post-operative length of hospitalisation - adjusted mean 15 (±2.53) versus 8 (±2.15) days (p=0.03). In a multi-variable regression analysis, in addition to ventricular dysfunction (ß coefficient=8.8, p=0.05), Glenn procedures performed before 4 months were independently associated with longer length of stay (ß coefficient=-6.9, p=0.03). CONCLUSION: We found that Glenn procedures performed after 4 months of age had shorter post-operative length of stay when compared to a younger cohort. These findings suggest that balancing timing of surgery to decrease the inter-stage period should take into consideration differences in post-operative recovery with earlier operations.


Assuntos
Derivação Cardíaca Direita/métodos , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Tempo de Internação/tendências , Medição de Risco , Fatores Etários , California/epidemiologia , Pré-Escolar , Feminino , Seguimentos , Humanos , Síndrome do Coração Esquerdo Hipoplásico/mortalidade , Lactente , Masculino , Período Pós-Operatório , Prognóstico , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências
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