European study showed that children with congenital anomalies often underwent multiple surgical procedures at different ages across Europe

Abstract

Aim Children with congenital anomalies often require surgery but data on the burden of surgery for these children are limited. Methods A population‐based record‐linkage study in Finland, Wales and regions of Denmark, England, Italy and Spain. A total of 91 504 children with congenital anomalies born in 1995–2014 were followed to their tenth birthday or the end of 2015. Electronic linkage to hospital databases provided data on inpatient surgical procedures and meta‐analyses of surgical procedures were performed by age groups. Results The percentage of children having surgery in the first year was 38% with some differences across regions and 14% also underwent surgery at age 1–4 years. Regional differences in age at the time of their first surgical procedure were observed for children with cleft palate, hydronephrosis, hypospadias, clubfoot and craniosynostosis. The children had a median of 2.0 (95% CI 1.98, 2.02) surgical procedures before age 5 years with children with oesophageal atresia having the highest median number of procedures (4.5; 95% CI 3.3, 5.8). Conclusion A third of children with congenital anomalies required surgery during infancy and often more than one procedure was needed before age 5 years. There was no European consensus on the preferred age for surgery for some anomalies.

Timing of Cardiac Surgical Interventions and Postoperative Mortality in Children With Severe Congenital Heart Defects Across Europe: Data From the EUROlinkCAT Study

“…The proportions of children having surgery were calculated using Kaplan–Meier survival estimates to allow for the censoring of children occurring on December 31, 2015, date of death, or date of emigration from the study region or country, as previously described in detail. 11 The numbers of surgical procedures the children had and the age at the time of the first surgery were non‐Gaussian with a few extreme outliers, and therefore they were reported as medians and interquartile ranges; meta‐analytic methods to combine all results across registries have been previously described elsewhere. 12 Briefly, quantile estimation methods were used to obtain pooled estimates of the median age at first operation and the 95% CIs using the metamedian package in R, version 4.0.3 (R Foundation for Statistical Computing, Vienna, Austria).…”

Impact of COVID-19 pandemic on rates of congenital heart disease procedures among children: Prospective cohort analyses of 26,270 procedures in 17,860 children using CVD-COVID-UK consortium record linkage data

“…For such patients, it is likely that they will require operations or percutaneous/hybrid interventions throughout their lifetimes. 5,6 On the other hand, certain types of heart condition, such as transposition of the great arteries , hypoplastic left heart syndrome or obstructed total anomalous pulmonary venous drainage, etc., are time sensitive and require immediate perinatal attention, while some conditions may remain stable despite longer delays. The prioritization of urgent, emergency and life-saving CHD procedures over elective procedures, as observed in our and other studies.…”

“…3 Children born with congenital heart diseases (CHD) commonly require repeat cardiac catheterization and surgical procedures (hereafter collectively referred to as procedures) across childhood to ensure they maintain healthy cardiac structure and function as they grow. [4][5][6] Several studies from different countries including China, 7 India, 8 Mexico, 9 Turkey, 10 Italy, 11 and the UK, 12 have explored the impact of the pandemic on procedures for children with CHD. These have compared the initial period, commonly the first 4 to 6 months, of the pandemic, with an equivalent pre-pandemic period, and report marked reductions in the rate of procedures during the early phase of the pandemic that were driven by a reduction in elective procedures.…”