Long-Term Healthcare Utilization in Patients Undergoing Congenital Heart Surgery: A 10-Year Statewide Analysis

Crook, Sarah; Dragan, Kacie; Woo, Joyce; Neidell, Matthew; Cook, Stephen A.; Hannan, Edward L.; Jacobs, Marshall L.; Bacha, Emile A.; Petit, Christopher J.; Robert, Vincent; Walsh-Spoonhower, Kathleen; Mosca, Ralph S.; Kumar, T.K. Susheel; Devejian, Neil; Kamenir, Steven A.; Alfieris, George M.; Swartz, Michael F.; Meyer, David J.; Paul, E.; Billings, John S.; Anderson, Brett R.

doi:10.1016/s0735-1097(22)02346-4

Cited by 3 publications

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Section: Methodsmentioning

confidence: 99%

“…Hispanic was used as the reference group for this analysis, given previous data that have demonstrated disparate outcomes among Hispanic and non-Hispanic Black patients, as compared with non-Hispanic White patients. 26,27 Clinical characteristics included fundamental CHD diagnosis, birth weight or weight at the time of surgery, gestational age at birth, presence of genetic syndrome, nonchromosomal syndrome, extracardiac structural abnormality, and presence of preoperative comorbidity. STS-CHSD defines fundamental diagnosis as the most complex cardiac anomaly or condition carried with a patient through life, through all operations and hospitalizations.…”

Section: Additional Explanatory Variablesmentioning

confidence: 99%

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Association Between Prenatal Diagnosis and Age at Surgery for Noncritical and Critical Congenital Heart Defects

Woo

Laternser

Anderson

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND: The relationship between the prenatal diagnosis of congenital heart defects (CHDs) and age at CHD surgery is poorly understood, despite the known relationships between age at surgery and long-term outcomes. The objective of this study was to determine the associations between prenatal diagnosis of CHD and age at surgery, and whether these associations differ for critical and noncritical CHDs. METHODS: This is a cohort analysis of patients aged 0 to 9 years who received their initial cardiac surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago between 2015 and 2021 with prenatal diagnosis as the exposure variable. All data were obtained from the locally maintained Society of Thoracic Surgeons Congenital Heart Surgery Database at Lurie Children’s Hospital. We used multivariable fixed effects regression models to estimate the strength of the association of prenatal diagnosis with age at surgery among patients with critical (surgery ≤60 days) and noncritical (surgery >60 days) CHDs. RESULTS: Of 1131 individuals who met inclusion criteria, 532 (47%) had a prenatal diagnosis, 428 (38%) had critical CHDs, 533 (47%) were female, and the median age at surgery was 119 days (interquartile range, 11–309 days). After controlling for demographics, comorbidities, and surgical complexity, the mean age at surgery was significantly younger in those with prenatally versus postnatally diagnosed critical CHD (7.1 days sooner, P <0.001) and noncritical CHDs (atrial septal defects [12.4 months sooner, P =0.037], ventricular septal defects [6.0 months sooner, P <0.003], and noncritical coarctation of the aorta [1.8 months sooner, P =0.010]). CONCLUSIONS: Younger age at CHD surgery, which is associated with postsurgical neurodevelopmental and physical outcomes, is significantly associated with prenatal CHD diagnosis. This relationship was identified for both critical and noncritical CHDs.

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Section: Methodsmentioning

confidence: 99%

Section: Additional Explanatory Variablesmentioning

confidence: 99%