An Analysis of Hospital Mortality After Cardiac Operations in Children With Down Syndrome

Dhillon, Gurpreet S.; Ghanayem, Nancy S.; Broda, Christopher R.; Lalani, Seema R.; Mery, Carlos M.; Shekerdemian, Lara; Staffa, Steven J.; Morris, Shaine A.

doi:10.1053/j.semtcvs.2020.06.037

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…Bidirectional Glenn palliation TOF/PA repair was associated with worse hospital mortality in children with DS. Further work will be evaluated cardiac and noncardiac comorbidities in DS patients led to higher mortality for specific cardiac lesions [57].…”

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confidence: 99%

Congenital Heart Disease and Surgical Outcome in Down Syndrome

Alsuhaymi¹

2022

Down Syndrome and Other Chromosome Abnormalities

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The prevalence of congenital heart disease has accounted for nearly one-third of all significant congenital anomalies worldwide. The first report about an association between cardiac anomalies and Down Syndrome was in (1876). Ten years after discovering of Down Syndrome and the credit of association between congenital cardiac anomalies and mongolism was suggested in (1894) by Garrod. There many studies performed to identify a correlation between genotype and phenotype in Down Syndrome, little is known about cardiovascular phenotype in Down Syndrome. Congenital heart disease is considered one of the highest causes of mortality and morbidity in Down Syndrome compared to patients with the same lesion of non-down. There is a big debate about surgical management and considered them as risk factors of surgery with precaution and recent technology, Down Syndrome considered as a normal patient in prognosis. This chapter aimed to shed the light on congenital heart disease in Down Syndrome and current knowledge in specific mutations associated with them and how the effect of innovative technology and management to treat them end at the same outcome and sometimes better based on recent research and Scoring System.

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Section: Author Detailsmentioning

confidence: 99%

Congenital Heart Disease and Surgical Outcome in Down Syndrome

Alsuhaymi¹

2022

Down Syndrome and Other Chromosome Abnormalities

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“…We chose this specific population as patients undergoing ASO have a relatively homogeneous perioperative course and would thus have similar predisposing factors and etiologies of PCE development. 16 – 18 Second, the ASO cohort is easily identified with International Classification of Diseases diagnosis and procedure codes (unlike many other congenital heart surgeries 19 ), mitigating concern for overlap with other pathologies. Lastly, we felt PHIS was an adequate database to answer these questions and identify ASO patients since a recent study demonstrated a 98% sensitivity for identification of ASO within the PHIS database compared to the Society of Thoracic Surgeons Congenital Heart Surgery Database.…”

Section: Introductionmentioning

confidence: 99%

Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review

Mikulski

Well

Subramanian

et al. 2023

World J Pediatr Congenit Heart Surg

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Background: Pericardial effusion (PCE) is a significant complication after pediatric cardiac surgery. This study investigates PCE development after the arterial switch operation (ASO) and its short-term and longitudinal impacts. Methods: A retrospective review of the Pediatric Health Information System database. Patients with dextro-transposition of the great arteries who underwent ASO from January 1, 2004, to March 31, 2022, were identified. Patients with and without PCE were analyzed with descriptive, univariate, and multivariable regression statistics. Results: There were 4896 patients identified with 300 (6.1%) diagnosed with PCE. Thirty-five (11.7%) with PCE underwent pericardiocentesis. There were no differences in background demographics or concomitant procedures between those who developed PCE and those who did not. Patients who developed PCE more frequently had acute renal failure (N = 56 (18.7%) vs N = 603(13.1%), P = .006), pleural effusions (N = 46 (15.3%) vs N = 441 (9.6%), P = .001), mechanical circulatory support (N = 26 (8.7%) vs N = 199 (4.3%), P < .001), and had longer postoperative length of stay (15 [11-24.5] vs 13 [IQR: 9-20] days). After adjustment for additional factors, pleural effusions (OR = 1.7 [95% CI: 1.2-2.4]), and mechanical circulatory support (OR = 1.81 [95% CI: 1.15-2.85]) conferred higher odds of PCE. There were 2298 total readmissions, of which 46 (2%) had PCE, with no difference in median readmission rate for patients diagnosed with PCE at index hospitalization (median 0 [IQR: 0-1] vs 0 [IQR: 0-0], P = .208). Conclusions: PCE occurred after 6.1% of ASO and was associated with pleural effusions and mechanical circulatory support. PCE is associated with morbidity and prolonged length of stay; however, there was no association with in-hospital mortality or readmissions.

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“…The reliability of the data has been assessed and confirmed by other researchers in the past. 12 Patient race, ethnicity, insurance status, age group, length of stay, discharge location, and discharge status were extracted.…”

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confidence: 99%

Trisomy 18: disparities of care and outcomes in the State of Texas between 2009 and 2019

et al. 2023

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Objective: To perform a statewide characteristics and outcomes analysis of the Trisomy 18 (T18) population and explore the potential impact of associated congenital heart disease (CHD) and congenital heart surgery. Study Design: Retrospective review of the Texas Hospital Inpatient Discharge Public Use Data File between 2009 and 2019, analysing discharges of patients with T18 identified using ICD-9/10 codes. Discharges were linked to analyse patients. Demographic characteristics and available outcomes were evaluated. The population was divided into groups for comparison: patients with no documentation of CHD (T18NoCHD), patients with CHD without congenital heart surgery (T18CHD), and patients who underwent congenital heart surgery (T18CHS). Results: One thousand one hundred fifty-six eligible patients were identified: 443 (38%) T18NoCHD, 669 (58%) T18CHD, and 44 (4%) T18CHS. T18CHS had a lower proportion of Hispanic patients (n = 9 (20.45%)) compared to T18CHD (n = 315 (47.09%)), and T18NoCHD (n = 219 (49.44%)) (p < 0.001 for both). Patients with Medicare/Medicaid insurance had a 0.42 odds ratio (95%CI: 0.20–0.86, p = 0.020) of undergoing congenital heart surgery compared to private insurance. T18CHS had a higher median total days in-hospital (47.5 [IQR: 12.25–113.25] vs. 9 [IQR: 3–24] and 2 [IQR: 1–5], p < 0.001); and a higher median number of admissions (n = 2 [IQR: 1–4]) vs. 1 [IQR: 1–2] and 1 [IQR: 1–1], (p < 0.001 for both). However, the post-operative median number of admissions for T18CHS was 0 [IQR: 0–2]. After the first month of life, T18CHS had freedom from in-hospital mortality similar to T18NoCHD and superior to T18CHD. Conclusions: Short-term outcomes for T18CHS patients are encouraging, suggesting a freedom from in-hospital mortality that resembles the T18NoCHD. The highlighted socio-economic differences between the groups warrant further investigation. Development of a prospective registry for T18 patients should be a priority for better understanding of longer-term outcomes.

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An Analysis of Hospital Mortality After Cardiac Operations in Children With Down Syndrome

Cited by 12 publications

References 27 publications

Congenital Heart Disease and Surgical Outcome in Down Syndrome

Congenital Heart Disease and Surgical Outcome in Down Syndrome

Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review

Trisomy 18: disparities of care and outcomes in the State of Texas between 2009 and 2019

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